Monaldi Archives for Chest Disease最新文献

{"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":"<p><p>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.</p>","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}

{"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":"<p><p>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.</p>","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}

{"title":"Transcatheter edge-to-edge mitral valve repair <i>versus</i> 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":"<p><p>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.</p>","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}

{"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":"<p><p>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.</p>","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}

{"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":"<p><p>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.</p>","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}

{"title":"Cardiac involvement of Gorlin-Goltz syndrome: new light among the shadows of an old congenital disorder.","authors":"Mihail Celeski, Andrea Segreti, Annunziata Nusca, Giuseppe Di Gioia, Raffaele Rinaldi, Gian Paolo Ussia, Francesco Grigioni","doi":"10.4081/monaldi.2025.3251","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3251","url":null,"abstract":"<p><p>Mutations in the PTCH1, PTCH2, or SUFU genes cause the hereditary, autosomal dominant Gorlin-Goltz syndrome (GGS), which is characterized by high penetrance and variable expressivity. Although its clinical manifestations are primarily marked by multiple basal cell carcinomas, other endocrine, neurological, ophthalmologic, genital, and respiratory alterations have been reported in the literature. Despite the association with cardiac fibromas, cardiovascular involvement is rarely reported. Here, we present a case of a patient with myocarditis of unknown origin, later diagnosed with GGS. We discuss the potential underlying mechanisms of this association, emphasizing the importance of recognizing cardiac manifestations in GGS individuals.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191220","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 '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'.","authors":"The Monaldi Archives For Chest Disease Editors","doi":"10.4081/monaldi.2025.3397","DOIUrl":"10.4081/monaldi.2025.3397","url":null,"abstract":"<p><p>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' by Caterina Oriana Aragona et al., Monaldi Arch Chest Dis, 2024, Accepted Manuscript, https://doi.org/10.4081/monaldi.2024.2972 IF: 1.1 Q4 NA. The Editors and Publisher of the Monaldi Archives for Chest Disease are 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://www.monaldi-archives.org/macd/article/view/3259).</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082020","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":"Virtual bronchoscopic navigation and guided radial endobronchial ultrasound for peripheral pulmonary lesions: harmonizing modalities to optimize accuracy.","authors":"Parul Mrigpuri, Sidharth Raj Yadav, Divyendu Sharma, Sonam Spalgais, Vidushi Rathi, Nitin Goel, Balakrishnan Menon, Raj Kumar","doi":"10.4081/monaldi.2025.3223","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3223","url":null,"abstract":"<p><p>Peripheral pulmonary lesions (PPLs) present a significant diagnostic challenge due to their location beyond the reach of traditional bronchoscopy. With lung cancer being the leading cause of cancer-related mortality worldwide, accurate and early diagnosis of PPLs is crucial. Virtual bronchoscopic navigation (VBN) combined with radial endobronchial ultrasound (R-EBUS) has emerged as a promising technique to enhance the diagnostic yield for these lesions. This retrospective observational study evaluated the diagnostic yield of VBN-guided R-EBUS in patients with PPLs identified on computed tomography. The study included nine patients who underwent VBN-guided R-EBUS biopsy sampling. Patient demographics, lesion characteristics, and procedural outcomes were analyzed using descriptive and inferential statistics. The mean age of the patients was 57.33 years, with a mean lesion size of 3.24 cm. The diagnostic yield of VBN-guided R-EBUS was 77.7% (95% confidence interval: 68.5-85.8%). Non-small cell carcinoma was the most frequent histopathological diagnosis (55.5%). Complications included bleeding in two patients (22.2%) and bronchospasm in one patient (11.1%), all managed conservatively. VBN-guided R-EBUS provides high diagnostic accuracy and a low risk of complications in patients with PPLs.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069588","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 interleukin-4 receptor α polymorphism in patients with asthma and its correlation with asthma severity.","authors":"Nidhi Girdhar, Karan Sharma, Satyajit Deshpande, Siddharth Sharma, Vishal Chopra, Anil Sontakke","doi":"10.4081/monaldi.2025.3095","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3095","url":null,"abstract":"<p><p>Asthma is a heterogeneous disease characterized by chronic airway inflammation. It is defined by the history of respiratory symptoms such as wheeze, shortness of breath, chest tightness, and cough that vary over time and intensity, together with variable expiratory airflow limitation. A personal history or a family history of allergy is the factor most strongly associated with the development of asthma. Our primary aim was to investigate interleukin-4 receptor α (IL-4Rα) polymorphism to determine whether the presence of the R576 IL-4Rα allele was associated with asthma and whether the presence of the R576 allele influenced the severity of asthma in affected individuals. The data obtained indicated asthmatic patients were characterized by a higher prevalence of positive family history of asthma (p<0.001) as compared to controls. It was found that the patients homozygous for mutant alleles had a 1.39-fold increased risk of asthma compared with individuals not homozygous for R576. Also, we found that females had higher odds (1.61-fold) of significant association with asthma (p=0.09; odds ratio=1.58). While this report clearly necessitates a more detailed study, it is plausible that IL-4 mutation has a significant role in the development of asthma and, thus, can play an important role in developing targeted therapy.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069583","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":"Significance of N-terminal pro-B-type natriuretic peptide levels in lung cancer.","authors":"Sinem İnan, Semra Bilaçeroğlu, Burcu Uludağ Artun","doi":"10.4081/monaldi.2025.3174","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3174","url":null,"abstract":"<p><p>High blood levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) have been shown in various malignancies. In lung cancer, the importance of NT-proBNP is not clear. In this study, we aimed to investigate the significance of the correlation of NT-proBNP levels in lung cancer with tumor stage, tumor diameter, histopathology, and specific sites of mediastinal metastasis: lymphadenopathy; pericardial, cardiac, major vessel, other mediastinal organ or lymphatic involvement/invasion. A total of 105 lung cancer and 120 control patients (chronic obstructive lung disease, interstitial lung disease, pulmonary thromboembolism, and pneumonia; 30/subgroup) with measured NT-proBNP levels were included retrospectively. Demographics, comorbidities, and echocardiographic findings in all patients, as well as histologic subtype, diameter, stage, and radiologic and/or pathologic mediastinal involvement/invasion of the tumor to the mediastinum in patients with lung cancer, were studied with regards to blood NT-proBNP levels. When lung cancer and control groups were compared globally or as subgroups with comorbidities, NT-proBNP levels did not show meaningful differences. However, NT-proBNP levels were determined to be 249 pg/mL and 88 pg/mL in lung cancer (n=68) and control subgroups (n=58) without comorbidities, respectively (p=0.001). Among lung cancer patients without comorbidities and those with cardiac, pericardial, major vascular, or other mediastinal involvement/invasion (lymphadenopathy, lymphatic, or other organ invasion) (n=27), the NT-proBNP level was 303 pg/mL, whereas it was 166 pg/mL in those without these mediastinal invasions (n=41) (p=0.031). There is a need for much larger, randomized studies to obtain evidence for the potential role of NT-proBNP as a helpful diagnostic biomarker for lung cancer. Clinical suspicion of malignancy may be posed if high NT-proBNP levels cannot be explained by all other risk factors and disorders or diseases. Furthermore, pericardial, cardiac, major vessel, or other mediastinal invasion/involvement should be sought when high NT-proBNP levels are determined in lung cancer patients without any comorbidities or risk factors for high NT-proBNP levels.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069585","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}