Monaldi Archives for Chest Disease最新文献

{"title":"Post-tuberculosis lung disease patients benefit from vaccinations as other respiratory conditions.","authors":"Giovanni Battista Migliori, Rosella Centis, Lia D'Ambrosio, Dina Visca, Onno W Akkerman, Denise Rossato Silva, Daria Podlekareva, Yousra Kherabi","doi":"10.4081/monaldi.2025.3525","DOIUrl":"10.4081/monaldi.2025.3525","url":null,"abstract":"<p><p>Dear Editor, A joint statement of the Italian respiratory, infectious diseases, and public health societies has been recently published on the best vaccination strategies in respiratory disease...</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152853","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":"Q fever endocarditis: a diagnostic challenge in a complex cardiological case.","authors":"Riccardo Rovelli, Elisa Brangi, Francesca Capasso, Martina Mazzini, Michela Raffo, Enrico Vizzardi","doi":"10.4081/monaldi.2025.3504","DOIUrl":"10.4081/monaldi.2025.3504","url":null,"abstract":"<p><p>Q fever endocarditis remains a diagnostic challenge today. Although it is a rare condition, it is crucial to recognize, as it represents the most common cause of endocarditis with persistently negative blood cultures. Here, we present the case of a 73-year-old woman with a history of coronary artery disease and systemic sclerosis who was admitted to the hospital complaining of asthenia and dyspnea. An echocardiographic examination revealed a highly mobile pedunculated mass on the mitral valve, suggestive of endocarditis. During the diagnostic workup, blood cultures were repeatedly negative, but serological testing confirmed positivity for Coxiella burnetii (IgG phase I 1:128). After diagnosing Q fever endocarditis, antibiotic therapy with doxycycline and hydroxychloroquine was initiated but was soon discontinued due to the development of renal impairment and thrombocytopenia. The clinical course was further complicated by cardiac arrest, leading to the patient's death. Given the rarity of this condition, this case highlights the importance of considering Q fever endocarditis in the differential diagnosis of blood culture-negative endocarditis and underscores the need for rapid diagnosis using advanced diagnostic techniques to improve patient outcomes.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318649","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 post-COVID syndrome across a multitude of health domains: a comparative analysis in previously hospitalized <i>versus</i> non-hospitalized COVID-19 survivors.","authors":"Elif Yildirim, Ipek Ozmen, Meral Sahin, Begum Ozpolat, Ahmet Kursat Karaman, Emine Aksoy","doi":"10.4081/monaldi.2025.3416","DOIUrl":"10.4081/monaldi.2025.3416","url":null,"abstract":"<p><p>This study aimed to evaluate the impact of post-COVID syndrome across a multitude of health domains among COVID-19 survivors via comparative analysis in previously hospitalized vs. non-hospitalized patients. A total of 158 adult COVID survivors who had symptoms that continued during post-COVID recovery were included in this prospective observational study. Data on handgrip strength, the 1-minute sit-to-stand test (1-MSTST), radiological scoring (CXR), Medical Research Council (MRC) dyspnea, Fatigue Assessment Scale (FAS), International Physical Activity Questionnaire, Post-COVID-19 Functional Status, Hospital Anxiety-Depression Scale, and Short Form Health Survey 36 (SF-36) health-related quality of life (SF-36 HRQoL) were recorded. Post-COVID 1st-month data revealed dyspnea (MRC scale ≥2 in 57.0% of patients) and fatigue (FAS scores ≥22 in 55.7%), a decrease in handgrip strength (60.0%) and physical activity (60.0%), poor HRQoL (SF-36 general health score ≤50 in 61.4%), and radiological disease progression (CXR score ≥3 in 56.8%) in at least half of patients, along with depression (34.8%) or anxiety (43.7%). Post-COVID 6th-month values for fat-free mass index (p=0.008), 1-MSTST recovery time (p=0.012), and 3rd-month CXR scores (p=0.024) were significantly higher, and 3rd-month SF-36 social functioning domain scores (p=0.026) were significantly lower in previously hospitalized vs. non-admitted patients. In conclusion, our findings indicate a diverse range of impairments in several health domains in COVID-19 survivors, while radiological disease progression and functional limitations were more remarkable in those with previous hospitalization. A comprehensive assessment of health status and persisting rehabilitation needs is necessary in COVID-19 survivors, regardless of disease severity.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486960","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":"Approach to mechanical ventilation: a simplified approach for a pulmonologist.","authors":"Pratap Upadhya, Sanjana H S, Harshith R, Vemuri Mahesh Babu, Karthik Balasoupramaniane, Zeenathaalam Nadaf","doi":"10.4081/monaldi.2025.3476","DOIUrl":"10.4081/monaldi.2025.3476","url":null,"abstract":"<p><p>Mechanical ventilation is a critical intervention for patients with respiratory failure, providing essential support for oxygenation and ventilation while reducing the work of breathing. It operates through key breath-phase variables: triggering (breath initiation), targeting (flow or pressure delivery), and cycling (ending inspiration). Various ventilation modes, including invasive and non-invasive methods, are tailored to patient needs. Non-invasive ventilation and high-flow nasal cannula are first-line options in acute respiratory distress, whereas invasive mechanical ventilation is necessary for severe cases. Optimal ventilatory strategies aim to prevent complications such as barotrauma, volutrauma, and dynamic hyperinflation by carefully adjusting parameters like tidal volume, respiratory rate, and positive end-expiratory pressure. One major challenge in mechanical ventilation is patient-ventilator dyssynchrony, where the patient's respiratory efforts do not align with the ventilator's cycles, leading to increased work of breathing and discomfort. Dyssynchrony can occur during the trigger, target, or cycle phases, requiring waveform analysis and ventilator adjustments to optimize synchrony. Weaning from mechanical ventilation follows a structured process involving readiness assessment, spontaneous breathing trials, and extubation. Successful weaning depends on maintaining stable respiratory function, with close monitoring to prevent post-extubation failure. Identifying and managing ventilatory complications, optimizing patient comfort, and ensuring an individualized approach to ventilator management are key to improving patient outcomes. This review provides a comprehensive understanding of mechanical ventilation, its principles, common challenges, and weaning strategies to guide effective clinical decision-making.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144259364","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":"Association between dietary live microbe intake and emphysema prevalence: evidence from the National Health and Nutrition Examination Survey 2009-2018.","authors":"Mengqi Wu, Yanhao Chen, Guangmin Liu","doi":"10.4081/monaldi.2026.3631","DOIUrl":"10.4081/monaldi.2026.3631","url":null,"abstract":"<p><p>Utilizing the National Health and Nutrition Examination Survey data from 2009 to 2018, this study examines the association between dietary live microbe consumption and emphysema prevalence in 24,174 participants. Dietary live microbe intake was classified into three categories: low, medium, and high. Adjusted logistic regression models demonstrated a significant inverse relationship between dietary live microbe intake and emphysema prevalence. Participants in the medium and high intake groups showed approximately 40% [odds ratio (OR)=0.595] and 60% (OR=0.378) reduced risk, respectively (p<0.00001). Subgroup analysis revealed a stronger protective effect in males, potentially linked to their higher oxidative stress and metabolic rates. These findings suggest that dietary live microbes may reduce emphysema risk by modulating immune responses and inflammation through the gut-lung axis. However, as this is a cross-sectional study, causality cannot be established, and further longitudinal research is required to validate these findings.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312185","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":"Evaluation of symptom control in chronic obstructive pulmonary disease after reinforcement of proper inhaler technique.","authors":"Tanya Jaiswal, Sparsh Gupta, Pooja Anand, Pranav Ish, Dhruv Sakkarwal, Divya Sahu","doi":"10.4081/monaldi.2025.3498","DOIUrl":"10.4081/monaldi.2025.3498","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) remains a leading cause of morbidity and mortality worldwide. Proper inhaler technique is a critical component of effective COPD management, yet it is often suboptimal in clinical practice. This study aimed to evaluate the impact of reinforcing proper inhaler techniques on COPD symptom control. This was a pre-post, prospective study conducted in the Department of Pharmacology at a tertiary care hospital in Delhi. A total of 118 COPD patients using inhalers were enrolled. A prospective study of 118 COPD patients using either dry powder inhalers or metered dose inhalers was carried out in the outpatient clinic of our hospital. Participants received structured demonstrations of proper inhaler technique at baseline (day 0), week 4, and week 8, with final evaluations at week 12. Symptom control was assessed using the COPD Assessment Test (CAT) score, and inhaler technique was evaluated using the Inhaler Technique Score (ITS). Adverse effects were monitored and documented. The study demonstrated a significant improvement in both CAT and ITS scores over the 12-week follow-up. The proportion of participants achieving optimal CAT scores (0-10) increased from 4.24% at baseline to 12.7% by week 12. Concurrently, the percentage of participants scoring the maximum ITS of 10 increased from 0% at baseline to 90.7% by week 12. Adverse effects were minimal, with 92.37% of participants reporting no adverse effects. A negative correlation was observed between changes in ITS and CAT scores, highlighting the effectiveness of the intervention in improving COPD symptom control. In conclusion, reinforcing proper inhaler technique through structured educational interventions significantly improves COPD symptom control, as evidenced by enhanced CAT and ITS scores. This study emphasizes the need for routine education and reinforcement of inhaler use in COPD management to achieve optimal clinical outcomes.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692383","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":"Hospital Anxiety and Depression Scale in patients undergoing extracorporeal circulation: an Italian cross-sectional study.","authors":"Gloria D'Angelo, Silvia Caucci, Alessandra Carminucci, Giuliana Ciapanna, Sara Sfredda, Elisa Baldoni, Alfredo Fioroni, Vito Maurizio Parato","doi":"10.4081/monaldi.2025.3425","DOIUrl":"10.4081/monaldi.2025.3425","url":null,"abstract":"<p><p>Globally, cardiovascular diseases (CVDs) are the major leading cause of death. Medical literature shows an association between CVDs and depressive symptoms, anxiety, low social support, and optimism. Also, cardiac surgery, even if the progress in extracorporeal circulation (ECC) ensures the patient's recovery \"ad integrum\", can provoke strong emotional processes, including states of anxiety and fear, leading to true depression disorders. The aim of this study is to identify the degree of anxiety and depression detected by means of the validated Hospital Anxiety and Depression Scale (HADS) following cardiac surgery with ECC. This is a single-center, cross-sectional, observational study that was conducted from 26/04/2023 to 23/10/2024. It involved patients who had undergone ECC for several reasons (coronary bypass, valve replacement, aortic root and arch replacement, trans-apical transcatheter aortic valve implantation) at Marche's Polytechnic University Hospital, who were subsequently admitted to the Rehabilitation Cardiology Unit of the \"Madonna del Soccorso\" Hospital in San Benedetto del Tronto. The study procedure involved the administration of the HADS questionnaire by a registered psychologist. We enrolled 100 patients with an average age of 71±4 years, predominantly male (64%) rather than female (35%). The results show that at the first administration of the HADS scale questionnaire (T0), the overall mean score is 14.54±5.86. In detail, the first subscale relating to anxiety reveals a mean value of 7.18±3.54, while the second subscale relating to depression shows a mean value of 7.36±3.09. At the second administration of the HADS scale questionnaire (T1), after a medium time interval of 22 days, the overall mean score is 4.09±4.11. In detail, the first subscale relating to anxiety reveals a mean value of 2.03±2.25, while the second subscale relating to depression shows a mean value of 2.87±2.39. A two-tailed test (t-test) was performed and showed a significant reduction of HADS values between the first (T0) and the second (T1) questionnaire administration [p<0.05 (df=99) (t-stat=25)]. The study shows a significant reduction of anxiety and depressive status in patients who underwent ECC and were subsequently admitted to a short-term psycho-educational intervention by a registered psychologist included in a multi-professional team of a Rehabilitation Cardiology Unit.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627693","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":"Relationship between the level of asthma control, lung function and bronchodilator response in asthmatic children on inhaled corticosteroids.","authors":"Javier Mallol, Viviana Aguirre-Camposano, Alejandro Gallardo, Pablo Córdova","doi":"10.4081/monaldi.2025.3257","DOIUrl":"10.4081/monaldi.2025.3257","url":null,"abstract":"<p><p>This study evaluated tools for assessing asthma control in 149 children on inhaled corticosteroids, focusing on the Asthma Control Test (ACT) and the Global Initiative for Asthma criteria (GINAc). It also explored the role of lung function (LF) tests, including spirometry and bronchodilator response (BDR), in identifying uncontrolled asthma. The GINAc identified 65.8% of children as having uncontrolled asthma, compared to 29.5% by the ACT (p<0.001). Spirometry and BDR results did not differ significantly between controlled and uncontrolled asthma groups. However, abnormal LF was more frequent in children with uncontrolled asthma identified by GINAc (18.4%) than in those with controlled asthma (5.9%; p=0.038). In ACT-identified uncontrolled cases, 18.2% had abnormal LF compared to 12.4% with controlled asthma (p=0.360). Similarly, BDR appeared in 17.3% of uncontrolled cases by GINAc and 11.8% in controlled cases, with 25% of ACT-identified uncontrolled cases showing BDR vs. 11.4% in controlled cases (p=0.037). Findings suggest GINAc detects more cases of uncontrolled asthma than ACT and highlights the potential value of including spirometry and BDR to complement asthma control questionnaires, mainly aiding in identifying controlled asthma cases with underlying abnormal LF or BDR.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112201","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":"ST-elevation myocardial infarction late-presenting patients: time for a new paradigm?","authors":"Francesco Antonio Veneziano, Francesca Frecentese, Raffaella Mistrulli, Roberta Veneziano","doi":"10.4081/monaldi.2025.3372","DOIUrl":"10.4081/monaldi.2025.3372","url":null,"abstract":"<p><p>Timely performed percutaneous coronary angioplasty (PCI) remains the most critical factor predicting favorable outcomes in patients with ST-elevation myocardial infarction (STEMI). Guidelines have traditionally identified the first 12 hours from symptom onset as the \"golden window\" for PCI. However, recommendations for patients presenting beyond this timeframe remain inconsistent. Late presenters are associated with worse outcomes and significantly higher rates of in-hospital mortality. Notably, the recent COVID-19 pandemic has further increased the prevalence of late presentations. Emerging imaging techniques now offer new opportunities to better characterize both patients and the pathological consequences of late-presented STEMI. Despite this progress, evidence supporting the adoption of imaging-guided strategies remains mixed. These advancements hold the potential to pave the way for personalized management approaches for this heterogeneous patient population soon. In this review, we explore the current evidence regarding the treatment of late presenters and discuss how emerging imaging techniques may transform clinical strategies in this challenging subset of STEMI patients.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin prick test wheal size: a potential predictor of respiratory allergies?","authors":"Gennaro Liccardi, Matteo Martini, Mauro Maniscalco, Maria Beatrice Bilò, Claudio Candia, Lorenzo Cecchi, Carmen Montera, Annaclaudia Giordano, Manlio Milanese, Fabio De Bartolomeis, Domenico Gargano, Mario Lo Schiavo, Francesco Madonna, Antonio Papa, Alfonso Pedicini, Alfonso Savoia, Paola Rogliani","doi":"10.4081/monaldi.2025.3326","DOIUrl":"10.4081/monaldi.2025.3326","url":null,"abstract":"<p><p>Dear Editor, The skin prick test (SPT) is the most commonly used method for diagnosing IgE-mediated sensitizations in conditions like bronchial asthma, allergic rhinitis, and food allergies...   ******************************** Promoted by the Italian Association of Hospital and Territorial Allergists and Immunologists (AAIITO - Campania region). *******************************.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}