Monaldi Archives for Chest Disease最新文献

{"title":"Inhalation beyond respiratory: the surprising applications of dry powder inhalers.","authors":"Akhil Akhil, Joysa Ruby Joseph, Venkatesh Dinnekere Puttegowda, Manasa V, Himadri Priya Gogoi, Vignesh S, Anjaneya Ph","doi":"10.4081/monaldi.2025.3172","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3172","url":null,"abstract":"<p><p>Dry powder inhalers (DPIs) are the newer devices whereby medicine is dispensed as a fine powder inhaled deeply into the lungs, which is more simplified and stable compared to the pressurized metered dose inhalers. DPIs were developed primarily for respiratory disorders such as asthma and chronic obstructive pulmonary disease but are being investigated for other uses. This review explicates the features of DPIs and how they are made, looking at their effectiveness in respiratory therapy, noting features such as usability, stability of the drugs, and flexibility. It also discusses the potential of systemic drug delivery using other routes, such as insulin for diabetes, calcitonin for osteoporosis, antibacterial agents, vaccines, dermal treatments, and ocular treatments, considering issues like stability and patients' compliance. Issues related to jet milling, spray drying, and supercritical fluid technology are also covered with regard to improving DPI performance. Hindrances, including formulation stability and regulatory issues, have been discussed as a way of demonstrating how innovation is needed to go beyond respiratory therapy.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240401","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":"Thoracic ultrasonography and pulmonary function tests in assessing lung function in acromegaly: a prospective matched case-control study.","authors":"Ayshan Mammadova, Meric Coskun, Zeynep Yalcinkaya, Ilhan Yetkin, Nurdan Kokturk","doi":"10.4081/monaldi.2025.3458","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3458","url":null,"abstract":"<p><p>Acromegaly is a rare disease characterized by elevated levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), leading to changes in various organ systems. However, the effects of this disease on pulmonary function are often overlooked. Early detection of pleural thickness and pulmonary function changes could offer significant clinical value. This study aimed to assess the role of thoracic ultrasonography (TUS) and pulmonary function tests in evaluating functional lung changes in patients with acromegaly and to explore the potential of ultrasonographic pleural assessment in predicting pulmonary involvement. This prospective single-center study, conducted at Gazi University Hospital between April and September 2022, included 34 patients with acromegaly and 34 healthy controls. Total lung capacity, residual volume, and forced vital capacity were significantly higher in patients with acromegaly compared to the control group (p=0.004, p=0.004, and p=0.005, respectively), while maximal inspiratory pressure and maximal expiratory pressure (MEP) were significantly lower (p=0.001 and p<0.001, respectively). Additionally, pleural thickness was higher in the acromegaly group (p<0.001). In the acromegaly group, MEP was negatively correlated with GH (r=-0.398, p=0.033), and pleural thickness was positively correlated with IGF-1 upper limit of normal (r=0.349, p=0.047). In conclusion, our study suggests that TUS combined with pulmonary function tests may help detect subtle thoracic changes in patients with acromegaly. This is the first study to evaluate TUS in these patients, and further research is needed to validate our findings.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139517","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":"Debunking e-cigarette myths: a public health necessity - disentangling facts from fiction.","authors":"Fatima Sajid","doi":"10.4081/monaldi.2025.3381","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3381","url":null,"abstract":"<p><p>Dear Editor, The global increase in e-cigarette usage, coupled with its promotion as a harm reduction tool, calls for a deeper examination of the myths vs. the scientific evidence...</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139408","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":"Respiratory and functional outcomes among severe COVID-19 infection survivors: a prospective observational study.","authors":"Syazatul Syakirin Sirol Aflah, Maria Kamal, Normaszuhaila Ab Hamid, Aminuddin Baki Amran, Sze Chiang Lui, Nurhayati Mohd Marzuki, Zamzurina Abu Bakar, Nabilah Salman Parasi Sulaiman, Noraishah Sulaiman, Karuthan Chinna, Asiah Kassim","doi":"10.4081/monaldi.2025.3499","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3499","url":null,"abstract":"<p><p>Patients who have severe to critical COVID-19 infection may experience persistent or new symptoms after discharge. Our objective is to determine the first-year post-discharge respiratory and functional outcomes in patients who survived COVID-19 infection. In this prospective and observational study, we recruited Malaysians above 18 years old who survived severe or critical COVID-19 and followed them up for 1 year. Patients completed the post-COVID-19 Functional Status (PCFS) scale, performed the 6-minute walk test, and a standard spirometry. In the final analysis, 94 patients were included. Median age was 57 years (24,86); 55 (57.3%) were men, and 20 (20.8%) required invasive ventilation. Overall, 45 (46.9%) had underlying hypertension, 33 (34.4%) had diabetes mellitus, 43 (44.8%) had hospital-acquired infection, 19 (19.8%) had raised liver enzymes, and 17 (17.7%) suffered pulmonary embolism. From discharge to 1 year following discharge, the percentage of patients with dyspnea reduced from 51.4% to 25.0%, while patients with cough reduced from 16.2% to none, and fatigue from 20.0% to 12.5%. The percentage of patients with PCFS of 0 increased from 48.0 to 62.5%, while no more patients reported PCFS scales of 3 or 4 after 24 weeks. The median 6-minute walk distance within 1 to 8 weeks was 375.0 m (108.0, 540.0). This increased to 500.0 m (330.0, 680.0) at 41 to 48 weeks. Throughout the follow-up, the percentage of patients with normal spirometry findings increased from none at 1 to 8 weeks to 43.8% at 41 to 48 weeks. In conclusion, patients gradually regained their functional status. Follow-up for patients with persistent symptoms and abnormal spirometry is necessary to determine their long-term outcome.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139429","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":"Removal of Expression of Concern for 'Interferon-γ release assay'.","authors":"The Publisher","doi":"10.4081/monaldi.2025.3733","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3733","url":null,"abstract":"<p><p>Removal of Expression of Concern for 'Interferon-γ release assay' by Malay Sarkar and Jasmine Sarkar, Accepted Manuscript, https://doi.org/10.4081/monaldi.2025.3258 The Publisher of the Monaldi Archives for Chest Disease is publishing this removal of expression of concern to inform readers that the investigation is complete and all earlier issues have been addressed. This notice supersedes the information provided in the Expression of Concern related to this article (https://doi.org/10.4081/monaldi.2025.3712).</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088123","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":"Burden and impact of pertussis in patients with chronic obstructive pulmonary disease exacerbation.","authors":"Archana Baburao, Vindhya Ponnathota, Aleena Mariam Mathew, Lakshminarayana Sura Anjanappa, Parinita Suresh, Thirthashree Kanabur","doi":"10.4081/monaldi.2025.3421","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3421","url":null,"abstract":"<p><p>Pertussis is highly prevalent in chronic obstructive pulmonary disease (COPD) patients, but it is underrecognized and underreported in India. This study aims to assess the burden and impact of pertussis in patients with COPD acute exacerbations and also evaluates the correlation between pertussis and COPD exacerbation. This is a prospective, observational, cross-sectional study enrolling 250 COPD patients admitted with moderate to severe exacerbation. Relevant investigations and oropharyngeal swabs for pertussis were collected from the study subjects. Among 250 patients with COPD acute exacerbation, a throat swab was positive for Bordetella pertussis in 40 (16.1%) of subjects. Among positive subjects, 45% had moderate and 55% had severe exacerbation. Pertussis-positive subjects had statistically significantly higher COPD assessment test scores (p=0.02), more exacerbations in the past year (p=0.03), associated coronary artery disease (p=0.007), pulmonary hypertension (p=0.001), significantly lower forced expiratory volume in 1 second values (p=0.04), exercise-induced desaturation (p=0.02), and belonged to group E GOLD category (p=0.01), compared to negative subjects with no significant difference in mortality. 55% of pertussis-positive patients required intensive care unit (ICU) admission compared to negative subjects (p=0.04). Further, within swab-positive patients, physiological indicators like peripheral oxygen saturation and diffusing capacity of the lung for carbon monoxide significantly predicted ICU need. This study demonstrates that COPD patients are potentially at increased risk of pertussis infection, and there is an association between pertussis infection and COPD severity. Vaccination coverage against pertussis among COPD patients is negligible. Large multicenter studies are required to establish the true burden of pertussis in COPD patients, including the healthcare costs.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114992","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":"Clinico-etiological profile and treatment outcome of hospitalized diffuse parenchymal lung disease patients: a prospective cohort study.","authors":"Komal Jharotiya, Mandeep Kaur Sodhi, Deepak Aggarwal, Varinder Saini, Komaldeep Kaur, Jeet Ram Kashyap","doi":"10.4081/monaldi.2025.3508","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3508","url":null,"abstract":"<p><p>Diffuse parenchymal lung disease (DPLD) is a group of more than 200 pulmonary diseases that affect the alveoli, pulmonary interstitium, and/or small airways. DPLD patients often present in the outpatient department and inpatient department with acute/subacute worsening in their symptoms. These worsenings are due to a variety of causes that include acute exacerbations (AE), bacterial/viral/fungal infections, pneumothorax, pulmonary thromboembolism, or cardiac compromise. However, regardless of the type of underlying DPLD and the etiology of acute worsening when AE develops, it poses serious difficulties for patients, families, doctors, and the medical system. The current study was performed to evaluate the clinical presentation, etiological factors, and hospital course of DPLD patients presenting with acute/subacute worsening in their respiratory symptoms. A total of 39 hospitalized DPLD patients were recruited as per the inclusion and exclusion criteria. On admission, all relevant investigations were done, and the patients were evaluated thoroughly. All these patients were managed as per standard guidelines with regular monitoring. Based on the clinical course, treatment outcome was categorized as improved (discharged from hospital) or shifted to intensive care unit/mechanical ventilation and improved or died. The mean age of the study subjects was 57.95±11.7 years. The most common symptom reported in the study was dyspnea, followed by cough and fever. The most common etiology observed in the study, leading to hospital admission in DPLD patients, was respiratory infections and AE, followed by cardiac diseases. Out of the total 39 hospitalized DPLD patients, 13 patients required invasive mechanical ventilation, whereas 26 patients (66.7%) were managed with oxygen support/non-invasive ventilation/high-flow nasal oxygen. The univariate logistic analysis showed that patients with diabetes, pedal edema, idiopathic pulmonary fibrosis, regional wall motion abnormalities, and cardiac causes of acute clinical worsening were significant risk factors for the need for mechanical ventilation. On performing multivariate regression, none of the variables was an independent significant risk factor of mechanical ventilation. It is recommended to actively undertake monitoring and treating DPLD in conjunction with managing various concomitant illnesses, which is vital for improving outcomes and lowering the risk of acute clinical worsening and respiratory compromise.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088148","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":"Proportion and number of chronic obstructive pulmonary disease cases attributable to potentially modifiable risk factors in Morocco.","authors":"Hajar Mahfoudi, Nassiba Bahra, Fatima Zahraebartal, Ibtissam El Harch, Soumaya Benmaamar, Moncef Maiouak, Nabil Tachfouti, Karima El Rhazi","doi":"10.4081/monaldi.2025.3377","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3377","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a major global health issue, especially in low- and middle-income countries, with significant mortality and economic impact. The study focuses on estimating the population attributable fraction (PAF) for modifiable risk factors, including smoking, secondhand smoke, occupational dust exposure, underweight, and tuberculosis history. The study aims to provide a rigorous assessment of these factors' contributions to COPD onset. Using national prevalence data and relative risk estimates from high-quality studies, the study calculated the PAF for modifiable COPD risk factors, including smoking and occupational dust exposure, applying Levin's and Smoking-Attributable Mortality, Morbidity, and Economic Costs formulas. Confidence intervals were determined through the simulated Wald interval method. In Morocco, the PAF for tobacco-related COPD was 47% for men and 5% for women, with over 1.2 million preventable cases in men and about 54,000 cases in women. The PAF for second-hand smoke at home was estimated at 4% in men and 5% in women. In the workplace, this fraction was higher in men (7%) than in women (4%). Occupational exposure to dust accounts for 13% of COPD cases in men and 12% in women, totaling 335,000 and 142,000 avoidable cases, respectively. Underweight contributes to 5% of cases in men and 2% in women, while tuberculosis accounts for over 1% of cases in both genders. COPD is largely influenced by modifiable risk factors like smoking and occupational exposure to dust. By targeting these risk factors, policymakers can significantly reduce future COPD cases.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082515","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":"The impact of pharmacist engagement on satisfaction with inhalers among patients with chronic obstructive pulmonary disease: a prospective interventional study.","authors":"Neha Ganesh, Madiwalayya Shivkantayya Ganachari, Anushree Deshpande","doi":"10.4081/monaldi.2025.3439","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3439","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD), predicted to become the third leading cause of death by 2030 with 3 million annual fatalities, imposes significant health and economic burdens due to its diverse respiratory conditions. Effective management strategies include symptom relief, disease progression control, and exacerbation prevention through interventions like smoking cessation, medication, rehabilitation, and vaccination, with inhalation therapy (pressurized metered-dose inhalers, dry powder inhalers, and nebulizers) playing a pivotal role, yet challenges in proper inhaler use persist, impacting disease control and healthcare utilization, necessitating improved patient education, inhaler designs, and healthcare system support. The objective of this study was to examine the inhaler proficiency of COPD patients and evaluate their health status, along with their satisfaction regarding inhaler usage. COPD patients were enrolled, with their demographics recorded before evaluating inhaler skills through teach-back; health status was assessed using the COPD Assessment Test (CAT) and satisfaction with inhaler use with the Feeling of Satisfaction with Inhalers Questionnaire (FSI-10), followed by pharmacist-led education and leaflet distribution, with 6-week and 3-month follow-ups for monitoring and support. Pharmacist involvement significantly improved COPD patients' satisfaction with inhalers, shifting from 91.81% to 36.36% reporting high satisfaction and from 8.18% to 63.63% reporting low satisfaction (p<0.001). Additionally, pharmacist intervention reduced the proportion of patients with very high CAT scores (>30) from 6.36% to 4.54% and high CAT scores (>20) from 48.18% to 24.54%, while increasing those with medium CAT scores (10-20) from 28.18% to 54.54% (p<0.001). Our study highlights that educating patients on proper inhaler techniques significantly improves COPD management, reducing exacerbations and hospital readmissions. Despite improvements in symptoms and quality of life (decreased CAT scores), patient satisfaction (FSI-10 scores) increased, suggesting effective intervention outcomes. The findings underscore the importance of enhancing patient education and adherence strategies, especially for those previously unaware of inhaler techniques. This emphasizes the need for comprehensive COPD management strategies addressing symptom relief and patient well-being.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081840","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":"Determinants of unsuccessful treatment outcome of pulmonary tuberculosis under the National Tuberculosis Elimination Program in Mohali district, India.","authors":"Aditi Gupta, Vidhu Mittal, Navdeep Singh, Anuradha Nadda","doi":"10.4081/monaldi.2025.3363","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3363","url":null,"abstract":"<p><p>Tuberculosis is a global healthcare concern, being the leading infectious cause of mortality by a single infectious agent. India bears the highest burden of tuberculosis. Disease outcome is an important indicator for the successful implementation of the National Program. Risk factors associated with unsuccessful outcomes must be identified, and differential care must be provided to those with risk factors. The study included all pulmonary tuberculosis patients registered from 1st October 2022 to 30th September 2023 at the Directly Observed Therapy Short Course Center, Dr. BR Ambedkar State Institute of Medical Sciences, Mohali, who received treatment. Data was collected from the Nikshay portal retrospectively. Out of 1103, 575 (52.13%) patients were declared cured, whereas 452 (40.97%) were declared treatment completed. A total of 19 (1.72%) pulmonary tuberculosis patients died during treatment, and 57 (5.16%) were declared failures. Advanced age [adjusted odds ratio (AOR) 4.028, 95% confidence interval (CI): 1.368-4.610, p=0.003], people living with HIV (AOR 0.185, 95% CI 0.031-1.082, p=0.05) and male gender (crude OR 1.611, 95% CI: 0.371-1.006, p=0.050) were associated with poor outcomes. Diabetes, retreatment, microbiological confirmation, and low body mass index were not statistically significant in the study. Age above 45 years, male sex, and HIV co-infection are determinants for unsuccessful treatment outcomes in patients with pulmonary tuberculosis.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082518","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}