Monaldi Archives for Chest Disease最新文献

{"title":"Rheumatic conditions associated with interstitial lung diseases: real-world outcomes in a secondary care setting.","authors":"Alex Francioni, Muhammad K Nisar, Natasha Ramsundar, Vijay Joshi, Judeson Gnanapragasam","doi":"10.4081/monaldi.2025.3073","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3073","url":null,"abstract":"<p><p>Management of rheumatic conditions associated with interstitial lung disease (r-ILD) requires expertise, often occurring in tertiary referral centers. We set up a combined rheumatology and respiratory service in a district general hospital (DGH) to avoid long patient journeys and improve experience. We evaluated the outcomes of 104 patients managed in this pilot service model. Referrals were triaged in monthly ILD multidisciplinary team meetings, and appropriate patients were booked into the clinic. All data were recorded electronically with full access to demographics, disease parameters, investigations, and drug management. Of the patients who attended follow-up, 51 (51%) had stable or improved symptoms, 58 (67%) had stable or improved computed tomography imaging, 50 (78%) had stable or improved forced vital capacity, and 40 (77%) had stable or improved diffusing capacity of the lungs for carbon monoxide. There were similar improvements in 6-minute walk tests. A total of 27 patients died, with 33% of these deemed as a direct result of their ILD. Our report confirms that r-ILD can be successfully managed in a DGH setting, with a large cohort obtaining good comparable clinical outcomes. We show that r-ILD services can be established locally to help overstretched tertiary care while developing local expertise in the management of r-ILD.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059776","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":"Assessment of diaphragmatic thickness as a predictor for intubation in pneumonia patients.","authors":"Elzahraa Wagdy Abdelfatah, Salwa Hussein Abdelmoneim, Hend Yahia Zakaria, Fatmaalzahraa Saad Abdalrazik","doi":"10.4081/monaldi.2025.3252","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3252","url":null,"abstract":"<p><p>Pneumonia, one of the major contributors to morbidity and mortality globally, often leads to serious complications such as respiratory failure. Diaphragmatic dysfunction, detected through ultrasound, may predict the need for intubation in patients with pneumonia. This study aimed to evaluate the roles of diaphragmatic thickness fraction (DTF) and diaphragmatic excursion (DE) as predictors of intubation in pneumonia patients. This follow-up cohort study involved 53 participants diagnosed with pneumonia. Diaphragmatic ultrasonography was performed to measure DTF and DE within 24 hours of admission. The mean age of the patients was 51.8±20.4 years, with 66% being male. Diabetes mellitus (DM) (p=0.000) and hypertension (HTN) (p=0.003) were significantly associated with the need for intubation. DE was significantly correlated with intubation (p=0.001). At a cut-off of 2.9 cm, DE demonstrated 100% sensitivity and 56% specificity for predicting intubation. DTF exhibited 92% sensitivity and 60% specificity at a cut-off of 0.52, with a positive predictive value of 85% and a negative predictive value of 54%. Diaphragmatic parameters, particularly DE and DTF, are significant predictors of intubation in pneumonia patients. Comorbidities such as DM and HTN also play a critical role, underscoring the importance of early identification of high-risk patients for timely intervention.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804780","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":"Medication adherence and its effect on health-related quality of life in respiratory tract infection patients using the St. George's Respiratory Questionnaire and the Medication Adherence Report Scale.","authors":"Sanatkumar Bharamu Nyamagoud, Sai Phalguna Prakash Chitralu, Princy Domnic Dsouza, Chandrashekhar Mallikarjun Patil, Vinod Ashok Koujalagi, Agadi Hiremath Viswanatha Swamy","doi":"10.4081/monaldi.2025.3338","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3338","url":null,"abstract":"<p><p>Respiratory tract infections (RTIs) are common and pose significant health challenges, particularly in economically disadvantaged regions. Medication adherence is believed to influence patient quality of life (QoL), but the extent of this impact remains unclear. A cross-sectional study was conducted at Vivekananda General Hospital, Hubballi, India, from August 2023 to January 2024 to assess the relationship between medication adherence and QoL in RTI patients. This study involved 200 patients from the pulmonology department. Medication adherence was evaluated using the Medication Adherence Report Scale, while QoL was assessed with the St. George's Respiratory Questionnaire (SGRQ). A two-way analysis of variance was performed to examine associations between adherence and QoL scores. No significant correlation was found between medication adherence and QoL. SGRQ total, symptoms, activity, and impact scores did not differ significantly between less adherent and highly adherent patients (p: 0.570-0.944). Medication adherence alone may not significantly affect QoL in RTI patients. Other factors, including disease severity, medication efficacy, comorbidities, and socioeconomic conditions, might have a greater influence. Further research is needed to explore these determinants and develop strategies to improve patient outcomes.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804799","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":"Prevalence of tobacco consumption among pulmonary tuberculosis patients and its correlation with tuberculosis incidence: a systematic review and meta-analysis in the Indian context.","authors":"Aninda Debnath, Ravindra Nath, Anubhav Mondal, Pankaj Chandrabhan Nathe, Jugal Kishore, Pranav Ish, Vidushi Rathi, Jagdish Kaur","doi":"10.4081/monaldi.2025.3324","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3324","url":null,"abstract":"<p><p>Tuberculosis (TB) and tobacco use are two intertwined public health challenges that significantly impact low- and middle-income countries, particularly India, which bears the highest global TB burden. Tobacco use exacerbates TB risk, progression, and treatment outcomes. Despite the established association, research on the prevalence of smoking and smokeless tobacco (SLT) use among pulmonary TB (PTB) patients in India remains limited. This systematic review and meta-analysis aim to estimate the prevalence of smoking and SLT use among PTB patients in India and evaluate the association between tobacco consumption and TB incidence and treatment outcomes. A systematic search was conducted across four databases (PubMed, Embase, Web of Science, and Scopus) for studies published up to September 30, 2024, adhering to PRISMA guidelines. Pooled prevalence estimates were calculated using random-effects models, and subgroup analyses examined variations by gender and treatment stage. Odds ratios (ORs) were used to assess the association between smoking and PTB. Sensitivity analyses and Egger's test were conducted to evaluate heterogeneity and publication bias. A total of 27 studies (n=9593 subjects) were included. The pooled prevalence of smoking among PTB patients was 31% [95% confidence interval (CI): 25-36%], while SLT use was 19% (95% CI: 13-26%). PTB patients were 2.5 times more likely to be smokers than non-TB controls (OR=2.51, 95% CI: 1.36-4.62). Smoking prevalence was highest among newly diagnosed patients (42%) and predominantly observed among males (38%). High heterogeneity (I²>98%) was observed across studies. To conclude, tobacco use is highly prevalent among Indian PTB patients, significantly contributing to disease burden. Integrating tobacco cessation strategies into India's National TB Elimination Program is critical to improving TB outcomes, reducing transmission, and addressing the dual burden of tobacco and TB.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804802","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 diagnostic value of inflammatory biomarkers in the diagnosis and treatment of influenza B in adults.","authors":"Ayshan Mammadova, Gunel Jeyranova","doi":"10.4081/monaldi.2025.3296","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3296","url":null,"abstract":"<p><p>Influenza can lead to various complications if not promptly diagnosed and treated. This study aims to assess the predictive value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation response index (SIRI), which are derived from routine blood parameters, in diagnosing influenza infection in adults. This study included 130 patients diagnosed with and treated for influenza B from 2022 to 2024. The control group comprised 130 healthy individuals. Influenza B diagnosis was confirmed using rapid antigen kits, and complete blood counts were analyzed via spectrophotometric/impedance methods, with statistical evaluation applied to the results. Among the 130 patients included, 55.3% (n=72) were male. Patients were categorized into two groups: those treated on an outpatient basis and those hospitalized. NLR, PLR, and SIRI values were significantly higher in hospitalized patients than in outpatients (p<0.001 for all parameters). In patients diagnosed with influenza B, NLR [6.11 (1.76-17.15)], PLR [266.66 (138.20-914.28)], and SIRI [3.56 (0.82-10.11)] values were significantly elevated compared to the control group [NLR 1.63 (0.45-2.22); PLR 99.21 (61.84-169.37); SIRI 0.73 (0.45-1.48)] (p<0.001 for all comparisons). The NLR threshold was set at 2.36, achieving 96.7% sensitivity and 100% specificity (p<0.001). The PLR threshold was 153.41 [area under the curve (AUC)=0.988, sensitivity: 93.3%, specificity: 92.9%, p<0.001], and the SIRI threshold was 1.36 (AUC=0.977, sensitivity: 93.1%, specificity: 92.9%, p<0.001), confirming the diagnostic relevance of these parameters. This study demonstrates that NLR, PLR, and SIRI, which are non-invasive, cost-effective, simple, and reproducible biomarkers, provide strong prognostic value in diagnosing and managing adult patients with influenza B, particularly in cases requiring hospitalization.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797035","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":"Clinical features of respiratory syncytial virus and influenza infections in hospitalized adults across three Italian regions.","authors":"Tommaso Bigoni, Franco Alfano, Marta Vicentini, Maria João Fonseca, Elisa Turriani, Elisa Vian, Micaela Romagnoli, Massimiliano Beccaria, Luca Pontalto, Michele Schincaglia, Federico Baraldi, Alberto Papi","doi":"10.4081/monaldi.2025.3410","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3410","url":null,"abstract":"<p><p>Acute respiratory infections (ARIs) are important causes of morbidity and mortality globally. Respiratory syncytial virus (RSV) is a highly transmissible viral pathogen that is associated with ARIs, with both RSV and influenza virus infections being leading causes of hospitalization in older (especially frail) individuals. However, prospectively collected data on the incidence of RSV infection are scarce. This prospective study sought to estimate the prevalence of and characterize RSV and influenza virus infection in hospitalized patients. Adult patients (≥18 years of age) who were admitted to the respiratory ward of three major hospitals in northern Italy were included in the study and, therefore, had a nasal swab and underwent routine clinical, laboratory, and imaging testing. The primary objective was to estimate the prevalence of influenza virus and RSV infection in these patients. A total of 246 patients were recruited, 36 of whom had a viral or bacterial respiratory infection. Of these, 9 (3.7% of the total included patients or 25.0% of those with any infection) tested positive for the influenza virus, 5 (55.6%) of whom developed acute respiratory failure, with one dying by 3 months post-discharge. A further 3 patients (1.2% of the total included patients or 8.3% of those with any infection) tested positive for RSV. The three patients with RSV had a greater level of dyspnea and greater severity than those with any infection, and all had pneumonia and developed acute respiratory failure, with one dying during hospitalization. Influenza and RSV infections were identified in patients hospitalized in respiratory wards in Northern Italy. The severe nature of the disease in these patients, including a high rate of pneumonia, emphasizes the importance of preventative measures to protect this vulnerable population and, in particular, vaccination.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755794","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":"Dilated cardiomyopathy - guidelines for personalization of care.","authors":"Antonella Spinelli, Gaetano Marino, Alfredo Macchiusi, Stefania Angela Di Fusco, Carlo Pignalberi, Furio Colivicchi","doi":"10.4081/monaldi.2025.3173","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3173","url":null,"abstract":"<p><p>The term dilated cardiomyopathy (DCM) refers to a family of diseases characterized by complex interactions between environment and genetic predisposition. Diagnostic tools such as cardiac magnetic resonance imaging should be systematically implemented in clinical practice to define the etiological cause and undertake a specific treatment. We present the case of a young man with DCM and severe left ventricular dysfunction. The patient has a family history of sudden cardiac death (SCD). He is affected by a psychiatric pathology and has a history of alcohol and drug addiction. Many diagnostic hypotheses have been considered for etiological research. The use of a wearable defibrillator to temporarily protect the patient from SCD risk pending the completion of the diagnostic path to establish DCM etiology and the implementation of optimal medical therapy was considered. However, because of the underlying psychiatric pathology and the possibility of poor adherence to the maintenance of the wearable device, the patients would not have been sufficiently protected. Due to the young age of the patient, it was decided to make a personalized therapeutic choice, and he underwent implantation of a subcutaneous defibrillator.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774767","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":"Role of detailed psychological evaluation and treatment in pulmonary rehabilitation programs for patients with chronic obstructive pulmonary disease.","authors":"Anna Jacob, Kranti Garg, Kashish Dutta, Varinder Saini, Deepak Aggarwal, Ajeet Sidana","doi":"10.4081/monaldi.2024.2849","DOIUrl":"10.4081/monaldi.2024.2849","url":null,"abstract":"<p><p>Psychological comorbidities are common in chronic obstructive pulmonary disease (COPD) but remain overlooked. Psychosocial interventions are deemed to promote mental health and optimize management. This study aimed to determine the role of detailed psychological evaluation and treatment in the comprehensive management of COPD. COPD patients after screening with the General Health Questionnaire-12 (GHQ-12) for psychological comorbidity were divided into three groups (26 patients each): i) group A [GHQ-12 score≤3, received pulmonary rehabilitation (PR) and standard medical management]; ii and iii) group B and C (GHQ-12 score>3, in addition, received management by a psychiatrist and counseling by a pulmonologist, respectively). At baseline and 8 weeks of follow-up, all participants were evaluated for respiratory [forced expiratory volume in the first second (FEV1), 6-minute walk distance (6-MWD), St. George's Respiratory Questionnaire (SGRQ), modified Medical Research Council (mMRC) dyspnea scale] and psychological [GHQ-12, Patient Distress Thermometer (PDT), Coping Strategy Checklist (CSCL), World Health Organization-Quality of Life-Brief (WHOQOL-Bref-26), and Depression Anxiety Stress Scale (DASS)] parameters. Psychological distress (GHQ-12>3) decreased significantly at follow-up, with 11.5% and 53.8% of patients having psychological distress in groups B and C, respectively, vs. baseline (p<0.001). mMRC score, SGRQ score, FEV1, and 6-MWD significantly improved in all three groups. Improvement in mMRC and SGRQ was maximal in group B when compared with the other groups. PDT, CSCL, and WHO-QOL-Bref-26 scores improved significantly at follow-up in all three groups, with maximum improvement in group B, followed by group C, and then group A. The DASS score also improved maximally in group B. Patients should be screened for psychological comorbidities using simple screening tools. PR plays an important role in improving the psychology of COPD patients. However, results are better with directed psycho-educative sessions by non-experts and best with definitive treatment by psychiatrists.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139974406","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":"Comments on \"QT interval prolongation in Takotsubo syndrome: a frightening feature with no major prognostic impact\".","authors":"John E Madias","doi":"10.4081/monaldi.2024.2879","DOIUrl":"10.4081/monaldi.2024.2879","url":null,"abstract":"<p><p>Dear Editor, Pinho et al. reported on the acquired corrected QT (QTc)-interval prolongation in a retrospective analysis of 113 patients (aged 67.6±11.7, 94.7% female)...</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652159","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":"A study to assess the relationship between vitamin D3 levels and the risk of acute exacerbation in patients with chronic obstructive pulmonary disease.","authors":"Ankit Lakra, Balbir Singh, Ashok Kumar Janmeja, Vanita Sharma, Arjun Kumar","doi":"10.4081/monaldi.2024.2885","DOIUrl":"10.4081/monaldi.2024.2885","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is one of the top three causes of mortality worldwide. Vitamin D deficiency in COPD has been associated with poor lung function and decreased muscle power, which further increases the risk of exacerbations. The role of vitamin D in preventing acute exacerbations of COPD has conflicting results in the literature. Hence, we planned this study to assess the relationship between vitamin D3 levels and the risk of acute exacerbations among COPD patients in a tertiary care center in northern India. This was a prospective randomized controlled trial that was performed on 100 consecutive stable COPD patients attending the Department of Respiratory Medicine at Maharishi Markandeshwar Medical College and Hospital, Solan, India. The patients with subnormal vitamin D3 levels (i.e., less than 30 ng/mL) were divided into the intervention and control groups. Baseline demographic profiles, lung function, COPD assessment test (CAT) score, modified Medical Research Council grade, and chest radiology were performed and repeated after 12 months in all these patients. All these parameters were recorded and compared with the baseline values obtained at the beginning of the study. Out of 100 subjects, 96 had vitamin D deficiency, of whom 48 were assigned to the intervention group and 48 to the control group. Among the 100 subjects, 74 (74%) were males and 26 (26%) were females, with a mean age of 66.9±9.4 years. The mean vitamin D level was 14.71±6.69 in these 96 patients. The vitamin D level improved after 3 months of supplementation to the mean level of 45.56±16.18 in the intervention group. Vitamin D supplementation was positively correlated with a decrease in the rate of acute exacerbations in the intervention group in terms of reduction in mean CAT score (4.17 in the intervention group and 1.43 in the non-interventional group, p<0.001), number of acute exacerbations (1.7 in the intervention group and -1.05 in the non-interventional group, p<0.001), and number of emergency visits (p=0.0121) during the 9-month period after attainment of a normal vitamin D level. Vitamin D supplementation plays a key role in COPD patients with D3 hypovitaminosis in decreasing COPD acute exacerbations, improving the CAT score, and reducing the number of emergency visits.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140023193","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}