Monaldi Archives for Chest Disease最新文献_第3页

Real-world data on home high-flow nasal cannula oxygen therapy in end-stage respiratory disease.

IF 1.1

Monaldi Archives for Chest Disease Pub Date : 2025-02-24 DOI: 10.4081/monaldi.2025.3269

Pedro Magalhães Ferreira, Mariana Ribeiro, Miguel Gonçalves, Carla Damas

{"title":"Real-world data on home high-flow nasal cannula oxygen therapy in end-stage respiratory disease.","authors":"Pedro Magalhães Ferreira, Mariana Ribeiro, Miguel Gonçalves, Carla Damas","doi":"10.4081/monaldi.2025.3269","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3269","url":null,"abstract":"High-flow nasal oxygen therapy (HFNOT) is a cornerstone treatment modality in severe acute hypoxemic respiratory failure, with benefits in improving oxygen deficit while normalizing breathing rate and having an effect on airway humidification. These physiological effects indicate a potential benefit in end-stage chronic respiratory failure. We aimed to assess the clinical impact of home HFNOT in reducing both exacerbation rates and overall disease burden in end-stage chronic respiratory disease. We designed a retrospective study including patients followed in the pulmonology department of a tertiary center who started home HFNOT until June 2023. Pre- and post-home HFNOT exacerbations and hospital admissions were registered, and each patient served as their own control for the statistical analysis. In total, 36 patients were included in the study: 24 patients (66.7%) with interstitial lung disease and 12 (33.3%) with obstructive lung disease. Overall, the median titrated fraction of inspired oxygen was significantly lower in obstructive patients; no significant differences were found between groups regarding titrated airflow. Obstructive patients had a significantly higher number of pre-treatment exacerbations and hospital stays. Both clinical subgroups presented less median overall post-treatment exacerbations and hospital admissions vs. pre-treatment start. Although mortality was high, home treatment was well tolerated by most patients, with only one patient interrupting high-flow therapy due to intolerance. Home HFNOT proved to be an overall feasible treatment strategy for patients with end-stage respiratory disease. Obstructive lung disease patients benefited the most from the treatment, possibly due to hypercapnia correction.","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484665","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}

引用次数: 0

Programmed cell death-ligand 1 expression and CD8 positive tumor-infiltrating lymphocyte density in non-small cell lung carcinoma and its association with histopathological grading.

IF 1.1

Monaldi Archives for Chest Disease Pub Date : 2025-02-21 DOI: 10.4081/monaldi.2025.3288

Niti Sureka, Sheetal Arora, Pranav Ish, Geetika Khanna

{"title":"Programmed cell death-ligand 1 expression and CD8 positive tumor-infiltrating lymphocyte density in non-small cell lung carcinoma and its association with histopathological grading.","authors":"Niti Sureka, Sheetal Arora, Pranav Ish, Geetika Khanna","doi":"10.4081/monaldi.2025.3288","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3288","url":null,"abstract":"Non-small cell lung carcinoma (NSCLC), comprising 85% of lung cancers, remains a leading cause of cancer mortality despite advances in treatment. Immunotherapy, particularly immune checkpoint inhibitors targeting the PD-1/PD-L1 axis, has revolutionized therapy, though outcomes vary. This study aimed to explore the association between PD-L1 expression, CD8 tumor-infiltrating lymphocyte (TIL) density, and histopathological grading in NSCLC. Our retrospective, single-centered cohort comprised 64 biopsy samples of NSCLC. PD-L1 and CD8 TILs density was assessed through immunohistochemistry. We also classified the tumors into four groups based on the PD-L1 and CD8-positive TIL statuses and evaluated their association with clinicopathological parameters. Male subjects were the predominant population in the study group (86%), with a mean age of 60 years. Most of the cases were smokers/ex-smokers (70.3%). Among 64 cases, PD-L1 positivity was observed in 62.5%, correlating with poorly differentiated tumors (grade 3) (p=0.03), suggesting its association with poor prognosis. Among PD-L1 positive cases, 55% had high expression and 45% had low expression. CD8 TIL density was low in 62.5% of cases and showed no significant correlation with clinical variables. Combined analysis revealed that 42.19% of cases were PD-L1+/CD8 low, a phenotype indicative of immune evasion and aggressive tumor behavior. Overall, our results emphasize that while PD-L1 immunohistochemistry remains a critical tool for identifying candidates for immunotherapy, it is not a standalone predictor of treatment response. Integrating CD8 TIL density provides additional prognostic information, potentially guiding more personalized treatment strategies.","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484598","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}

引用次数: 0

Effect of high flow nasal cannula versus conventional nasal cannula oxygen therapy in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration.

IF 1.1

Monaldi Archives for Chest Disease Pub Date : 2025-02-18 DOI: 10.4081/monaldi.2025.3246

Stuti Gupta, Rohit Kumar, Neeraj Kumar Gupta, Manu Madan, Pranav Ish, Rajnish Kaushik, Tanmaya Talukdar, Nitesh Gupta

{"title":"Effect of high flow nasal cannula versus conventional nasal cannula oxygen therapy in patients undergoing endobronchial ultrasound-guided transbronchial needle aspiration.","authors":"Stuti Gupta, Rohit Kumar, Neeraj Kumar Gupta, Manu Madan, Pranav Ish, Rajnish Kaushik, Tanmaya Talukdar, Nitesh Gupta","doi":"10.4081/monaldi.2025.3246","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3246","url":null,"abstract":"Patients undergoing endobronchial ultrasound-guided fine needle aspiration may have multiple comorbidities, contributing to higher risks of hypoxia and adverse events, such as arrhythmias. The current study compared the efficacy of two oxygenation modalities: the high-flow nasal cannula (HFNC) vs. conventional oxygen therapy (CNC). Patients were randomized to either the HFNC or the CNC arm. HFNC and CNC were initiated and escalated as per predefined protocols. The number of desaturation events [fall in saturation of peripheral oxygen (SpO2) by 3% from the baseline] and change in levels of transcutaneous CO2 (tcCO2) from baseline were noted. Subgroup analysis was done in patients with cardiopulmonary comorbidities and in patients with SpO2<97%. A total of 122 patients were randomized. Overall, there was no significant difference in the number of desaturation events and change in tcCO2 levels; however, in patients with cardiopulmonary comorbidities (obstructive sleep apnea, heart diseases, and stable chronic obstructive airway disease), 50% in the HFNC arm had no desaturation compared to 11.7% in the CNC arm (p=0.007). 41.17% of patients in the HFNC arm had a rise in tcCO2 levels, compared to 36.11% of patients in the CNC arm (p>0.5). In patients with SpO2<97%, 48.88% in the HFNC arm had no desaturations compared to 14.70% in the CNC arm (p=0.001); there was no statistical difference in rise in tcCO2. Hence, HFNC would be a better modality for oxygenation in patients with a high risk of hypoxia without increasing the risk of hypercapnia.","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450859","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}

引用次数: 0

Dual device intervention for stroke prevention and bradycardia: a case report.

IF 1.1

Monaldi Archives for Chest Disease Pub Date : 2025-02-12 DOI: 10.4081/monaldi.2025.3219

Fulvio Cacciapuoti, Salvatore Crispo, Davide D'Andrea, Crescenzo Materazzi, Salvatore Chianese, Simona Cotena, Rossella Gottilla, Valentina Capone, Ciro Mauro

{"title":"Dual device intervention for stroke prevention and bradycardia: a case report.","authors":"Fulvio Cacciapuoti, Salvatore Crispo, Davide D'Andrea, Crescenzo Materazzi, Salvatore Chianese, Simona Cotena, Rossella Gottilla, Valentina Capone, Ciro Mauro","doi":"10.4081/monaldi.2025.3219","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3219","url":null,"abstract":"Atrial fibrillation significantly increases the risk of thromboembolic events, necessitating anticoagulation for stroke prevention. However, patients with a history of intracranial hemorrhage pose unique management challenges, particularly regarding the use of anticoagulants and the need for dual antiplatelet therapy following procedures like percutaneous coronary intervention. In addition, the occurrence of bradyarrhythmias often necessitates pacing, underscoring the importance of innovative strategies such as left atrial appendage closure devices and leadless pacemakers to manage atrial fibrillation effectively while minimizing hemorrhagic risks. A 61-year-old man with permanent atrial fibrillation, recent intracerebral hemorrhage, and bradycardia presented with dizziness and recurrent syncopal episodes. During hospitalization, he underwent coronary angiography and percutaneous coronary intervention with drug-eluting stent placement in the left anterior descending and right coronary arteries. Due to anticoagulation risks, he subsequently underwent left atrial appendage closure with the LAmbre™ device and received an Aveir™ leadless pacemaker. Both procedures were successful, and he was discharged in stable condition. This case highlights how a combination of left atrial appendage closure, leadless pacing, and coronary intervention provided effective stroke prevention, heart rate control, and ischemic management in a high-risk atrial fibrillation patient. These strategies avoided the prolonged use of anticoagulants while addressing the patient's cardiovascular and hemorrhagic risk.","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411479","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}

引用次数: 0

Assessing the key factors contributing to non-adherence to pulmonary tuberculosis treatment: a descriptive study.

IF 1.1

Monaldi Archives for Chest Disease Pub Date : 2025-02-07 DOI: 10.4081/monaldi.2025.3262

Mariam Lakara, Anil Kumar Patidar, Anil Sharma

{"title":"Assessing the key factors contributing to non-adherence to pulmonary tuberculosis treatment: a descriptive study.","authors":"Mariam Lakara, Anil Kumar Patidar, Anil Sharma","doi":"10.4081/monaldi.2025.3262","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3262","url":null,"abstract":"Tuberculosis (TB) remains a significant public health challenge, particularly in developing nations like India, where it imposes a considerable burden. This descriptive cross-sectional study aimed to assess the factors affecting noncompliance with TB medications among pulmonary TB patients in an Indian community. A total of 215 participants were selected through non-probability purposive sampling. Data on factors contributing to non-adherence were collected using a structured self-administered questionnaire. Demographic characteristics, including age, gender, education, marital status, occupation, habitat, income, diagnosis, and duration since diagnosis, were recorded and analyzed. Key factors contributing to non-adherence were categorized into personal, economic, social, psychological, health facility, and technological factors. The results demonstrated that the non-adherence rate was 48.3%, while 51.7% of participants exhibited adherence to TB treatment. Discontinuing medication to feel better significantly increased noncompliance risk, especially for those who stopped \"most of the time\" vs. those who never stopped (odds ratio = 8.693, 95% confidence interval: 3.179-23.77). This study reveals that non-adherence to pulmonary TB treatment is influenced by a range of factors, including personal, economic, social, psychological, health facility, and technological factors, highlighting the need for multifaceted interventions to improve adherence.","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366506","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}

引用次数: 0

Transcatheter edge-to-edge mitral valve repair versus medical therapy for secondary mitral regurgitation: a meta-analysis of randomized controlled trials.

IF 1.1

Monaldi Archives for Chest Disease Pub Date : 2025-02-06 DOI: 10.4081/monaldi.2025.3264

Emídio Mata, Bárbara Lage Garcia, Mariana Tinoco, Margarida Castro, Luísa Pinheiro, João Português, Francisco Ferreira, Silvia Ribeiro, Bruno Melica, António Lourenço

{"title":"Transcatheter edge-to-edge mitral valve repair versus medical therapy for secondary mitral regurgitation: a meta-analysis of randomized controlled trials.","authors":"Emídio Mata, Bárbara Lage Garcia, Mariana Tinoco, Margarida Castro, Luísa Pinheiro, João Português, Francisco Ferreira, Silvia Ribeiro, Bruno Melica, António Lourenço","doi":"10.4081/monaldi.2025.3264","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3264","url":null,"abstract":"Secondary mitral regurgitation (SMR) is associated with increased hospitalizations and mortality. Clinical trials comparing mitral valve transcatheter edge-to-edge repair (M-TEER) with guideline-directed medical therapy (GDMT) show conflicting results, but the RESHAPE-HF2 trial offers new insights. This study aims to assess the M-TEER effect in addition to GDMT in reducing all-cause mortality, cardiovascular death, and heart failure hospitalizations (HHF) in patients with SMR when compared to GDMT alone. On September 2, 2024, PubMed, Cochrane CENTRAL, Scopus, and Web of Science were searched for randomized controlled trials comparing M-TEER in addition to GDMT with GDMT in SMR patients with heart failure. A study-level random-effects meta-analysis was conducted using trial-reported point estimates. Seven records from three trials (COAPT, MITRA-FR, RESHAPE-HF2) involving 1426 participants were included. At 24 months, M-TEER (using MitraClip®) significantly reduced the first HHF [hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.45-0.96] and all HHF (HR 0.63, 95% CI 0.49-0.81). However, no significant reduction was observed in all-cause mortality (HR 0.76, 95% CI 0.57-1.01) or cardiovascular death (HR 0.77, 95% CI 0.56-1.06). The intervention group had more patients in the New York Heart Association class I/II at 12 and 24 months but no significant improvement in 6-minute walk test performance at 12 months. High trial heterogeneity requires careful interpretation of pooled estimates. Differences in medical therapy and patient characteristics likely affected outcomes across trials. While M-TEER demonstrates benefits in reducing HHF, its effectiveness in reducing mortality remains inconclusive. The degree of left ventricular enlargement may have influenced outcomes, underscoring the importance of careful patient selection.","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366631","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}

引用次数: 0

Tobacco prevalence among adults in the urban slums of Delhi: results from a cross-sectional survey.

IF 1.1

Monaldi Archives for Chest Disease Pub Date : 2025-02-05 DOI: 10.4081/monaldi.2025.3217

Shyam Kanhaiya Saroj, Tushti Bhardwaj, Archana Kaushik

{"title":"Tobacco prevalence among adults in the urban slums of Delhi: results from a cross-sectional survey.","authors":"Shyam Kanhaiya Saroj, Tushti Bhardwaj, Archana Kaushik","doi":"10.4081/monaldi.2025.3217","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3217","url":null,"abstract":"Slum areas exhibited a marked prevalence of elevated tobacco consumption rates, prompting the investigation to assess the extent and perspectives of tobacco usage among the residents in these regions. The present study aimed to evaluate the prevalence and attitudes toward tobacco use within five distinct slum localities in close proximity to the tobacco cessation center. During a house-to-house visit, a cross-sectional survey was conducted in five different slum areas, coded as Zone 1 to Zone 5. To ensure a representative sample, 20% of households were randomly selected from each slum. The survey utilized a pre-designed, pretested, and semi-structured questionnaire to collect relevant data. A total of 274 households provided consent to participate in the survey. The variations in tobacco prevalence were observed across all five slums, ranging adult tobacco prevalence from 16.3% to 36.7%. Tobacco use prevalence differed significantly by gender, with 86.1% males and 13.9% females. Smokeless tobacco was the most preferred method of tobacco use. Notably, 43.8% of adult tobacco users expressed their willingness to quit tobacco usage, out of which 22.3% were female. A large proportion (70.4%) of total adult women tobacco users showed their willingness to quit, while the corresponding percentage for men was only 39.5%. This study highlights the high prevalence of tobacco use and the limited awareness of cessation services among users in nearby slums despite the proximity to cessation centers and mandatory tobacco cessation helpline numbers on tobacco packets. However, during the awareness session, individuals exhibited interest in quitting tobacco consumption.","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191187","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}

引用次数: 0

Chronic obstructive pulmonary disease and heart failure in real life: the tip of the iceberg in the sea of comorbidities. A prospective observational study.

IF 1.1

Monaldi Archives for Chest Disease Pub Date : 2025-02-04 DOI: 10.4081/monaldi.2025.3157

Ombretta Para, Marco Vanetti, Chiara Dibonaventura, Davide Salerno, Lorenzo Caruso, Christian Carleo, Asim Raza, Carlo Nozzoli, Antonio Spanevello

{"title":"Chronic obstructive pulmonary disease and heart failure in real life: the tip of the iceberg in the sea of comorbidities. A prospective observational study.","authors":"Ombretta Para, Marco Vanetti, Chiara Dibonaventura, Davide Salerno, Lorenzo Caruso, Christian Carleo, Asim Raza, Carlo Nozzoli, Antonio Spanevello","doi":"10.4081/monaldi.2025.3157","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3157","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) and heart failure (HF) are two of the most common conditions treated in internal medicine. Although it is known that these diseases often coexist, the specific characteristics of the affected patients and the prognostic implications are not yet well understood. Managing patients with both COPD and HF requires an integrated treatment approach. The aim of the study was to examine the association between COPD and HF. We conducted a prospective observational cohort study. All consenting patients admitted to the Internal Medicine Department from the Emergency Department with known or strongly suspected COPD were enrolled. A total of 144 patients were included, with 47.2% of them also having HF, distributed among the various HF subcategories as follows: 10.4% with HF with reduced ejection fraction (HFrEF), 3.5% with HF with mild-reduced ejection fraction, and 33.3% with HF with preserved ejection fraction (HFpEF). This result is consistent with the literature, which suggests a higher prevalence of COPD in patients with HFpEF compared to HFrEF. A Doppler echocardiography was performed during hospitalization. Some variables showed a statistically significant difference when comparing patients with COPD and HF to those with COPD without HF. Interestingly, the follow-up at 3 and 6 months post-discharge revealed higher mortality in patients with HF, with an odds ratio (95% confidence interval) of 10.0 (1.2-82.2). This study could contribute to a better understanding of the prognostic implications arising from the coexistence of COPD and HF, emphasizing the importance of a patient-centered approach in managing multiple comorbidities.","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191185","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}

引用次数: 0

Cardiac involvement of Gorlin-Goltz syndrome: new light among the shadows of an old congenital disorder.

IF 1.1

Monaldi Archives for Chest Disease Pub Date : 2025-02-03 DOI: 10.4081/monaldi.2025.3251

Mihail Celeski, Andrea Segreti, Annunziata Nusca, Giuseppe Di Gioia, Raffaele Rinaldi, Gian Paolo Ussia, Francesco Grigioni

引用次数: 0

Removal of Expression of Concern for 'Lipid-lowering therapy in patients with coronary heart disease: an Italian real-life survey. Results from the Survey on Risk FactOrs and CardiovascuLar secondary prevention and drug strategieS (SOFOCLES) in Italy'.

IF 1.1

Monaldi Archives for Chest Disease Pub Date : 2025-01-30 DOI: 10.4081/monaldi.2025.3397

The Monaldi Archives For Chest Disease Editors

引用次数: 0