Monaldi Archives for Chest Disease最新文献

{"title":"Promoting effective teamwork in the cardiothoracic surgery department: strategies for success.","authors":"Firas Aljanadi","doi":"10.4081/monaldi.2025.2977","DOIUrl":"https://doi.org/10.4081/monaldi.2025.2977","url":null,"abstract":"<p><p>In daily practice, teamwork is of paramount importance within the healthcare settings, particularly in specialized fields such as cardiothoracic surgery. This is due to the fact that collaboration, communication, and synchronization play a vital role in ensuring successful patient outcomes. The aim of this paper is to propose strategies to promote effective teamwork within a cardiothoracic surgical setting, elaborating general teamwork principles and applicable concepts from healthcare.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607152","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":"Unveiling the role of cartridge-based nucleic acid amplification test in extrapulmonary tuberculosis diagnosis: insights from a cross-sectional study.","authors":"Anil Sontakke, Rajasi Bundale, Sagar Kolte, Nidhi Girdhar, Hrishikesh Gaikwad, Harshal Ital","doi":"10.4081/monaldi.2025.3238","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3238","url":null,"abstract":"<p><p>Extrapulmonary tuberculosis (EPTB) is a multifaceted disease that could potentially impact nearly all organs. Current global data indicate a significant variation in the proportion of EPTB among all tuberculosis cases, ranging from 15% to 53%. Clinicians in India express concerns about the efficacy of the cartridge-based nucleic acid amplification test (CBNAAT) in EPTB, as its yield frequently does not align with the findings of the World Health Organization meta-analysis. Hence, the present study was conducted to evaluate the diagnostic yield of CBNAAT in EPTB at a tertiary care hospital. Specifically, the present hospital-based observational cross-sectional study was conducted at the Department of Respiratory Medicine at a tertiary care hospital from February 2024 to April 2024. A total of 52 patients with presumptive EPTB were enrolled. Demographic information, clinical history, and clinical examination findings were recorded with the help of a standard, semi-structured, pre-validated case record proforma. A composite reference standard (CRS), which was defined by clinical, radiological, laboratory, and histopathological findings and treatment response to antitubercular therapy along the course, was considered. The statistical software, namely SPSS 22.0, was used for the analysis of the data. Among a total of 52 patients, the mean age of patients was 37.42±16.18 years, with the proportion of males being 59.62%. The majority of patients had tuberculosis pleural effusion (63.46%). The pooled diagnostic yield of CBNAAT showed sensitivity and specificity of CBNAAT compared to CRS of 22.22% and 100%, respectively. Culture had the highest sensitivity in diagnosing EPTB in the study population, as compared to CBNAAT, thereby emphasizing the importance of diagnosis by culture method.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607156","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":"Bronchoscopic valve therapy for tuberculosis: a scoping review.","authors":"Kshitij Agarwal, Adam T Gray, Tudor P Toma, Valentina Luzzi, Lorenzo Corbetta","doi":"10.4081/monaldi.2025.3281","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3281","url":null,"abstract":"<p><p>The management of tuberculosis (TB) presents significant challenges, particularly in the context of multidrug-resistant TB (MDR-TB) and TB-HIV co-infection. Traditional surgical interventions, such as lung resection and pneumothorax induction, have largely been phased out with the advent of modern antibiotic regimens. However, emerging evidence suggests that endobronchial interventions, specifically the use of unidirectional valves, have potential in supporting the treatment of MDR-TB. The objective of this review is to demonstrate the feasibility of closure of tubercular cavities using endobronchial valves, resulting in improved clinical outcomes and sputum smear conversion. PubMed was searched from inception to September 2024. The small studies reviewed here demonstrate the feasibility of tubercular cavity closure using endobronchial valves, resulting in improved clinical outcomes and sputum smear conversion. Yet, limited access to Food and Drug Administration-approved valves and funding challenges hinders large-scale trials. To address these limitations, further evidence is needed within improved international collaboration. We suggest that international prospective trials and innovation are needed. Such collaborative efforts would clarify the role of valves in TB treatment and hopefully lead to the development of simpler and more affordable occlusive devices that would benefit patients with MDR-TB, particularly in low-income countries.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568791","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 distress thermometer: a promising tool to screen patients with chronic respiratory diseases for emotional distress.","authors":"Sherif Mohamed, Omar Abdelwahab, Ashraf M Elsherbiny, Nashwa Abd El-Aziz","doi":"10.4081/monaldi.2025.3018","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3018","url":null,"abstract":"<p><p>Patients with chronic respiratory diseases have variable degrees of emotional distress (ED). Chronic illness-related ED has been shown to be an independent factor for inefficient self-management as well as an essential factor for clinical deterioration and the quality of life in patients with chronic respiratory diseases. The distress thermometer (DT) comprises two distinct components: a visual analog scale, which resembles a thermometer, and a 39-problem list (PL) composed of 5 different categories: family, emotional, practical, spiritual/religious, and physical problems. DT has been approved as very effective in screening patients for ED in oncological and non-oncological settings. The COVID-19 pandemic has stimulated investigators to develop a modified DT (m-DT) that can be implemented for patients with COVID-19. This m-DT proved effective in screening adults, adolescents, and pregnant women with COVID-19 for ED. DT has been utilized in patients with chronic medical conditions in the non-oncological context, yet it was underutilized in those with chronic respiratory diseases. We believe that DT, with its advantages, represents a handy tool for screening patients with chronic respiratory diseases. The DT-associated PL is relatively comprehensive and covers almost all social, spiritual, financial, and emotional aspects of the screened individual's life. Screening of patients with cancer using DT has revealed encouraging results. Similar results among patients with chronic respiratory diseases are expected. DT can be utilized efficiently to deal with mental health issues routinely as a part of rehabilitation programs for chronic respiratory disorders. Further studies are warranted.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568794","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 \"Smoking patterns and outcomes of severe SARS-CoV-2 infection: a retrospective cohort study\".","authors":"Marco Rossato, Angelo Di Vincenzo","doi":"10.4081/monaldi.2025.3430","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3430","url":null,"abstract":"<p><p>Dear Editor, We have read with interest the recently published paper by Beronja et al. reporting the clinical outcomes in a group of patients hospitalized for COVID-19 being current smokers or not and concluding that a history of cigarette smoking (past or active) is an independent factor for negative prognosis in COVID-19 patients...</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568792","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 and impact of anxiety and depression in patients with chronic obstructive pulmonary disease: a comparative analysis of post-tuberculosis and non-tuberculosis chronic obstructive pulmonary disease cases.","authors":"Eshutosh Chandra, Shipra Anand, Amitesh Gupta, Roopam Jha, Irshad Ahmad","doi":"10.4081/monaldi.2025.3278","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3278","url":null,"abstract":"<p><p>Chronic obstructive pulmonary disease (COPD) is a prevalent and debilitating condition, increasingly recognized for its complex interaction with psychiatric disorders such as anxiety and depression. This study assesses and compares the prevalence of anxiety and depression among COPD patients, including those with a history of pulmonary tuberculosis (TB), and examines their associations with COPD severity. This descriptive, cross-sectional study included 100 patients diagnosed with COPD, aged 40 to 80 years. Patients underwent comprehensive clinical evaluation, including spirometry and COPD assessment tests, and were assessed for anxiety and depression using the Hospital Anxiety and Depression Scale. Participants were classified based on their COPD status and history of TB. Data on sociodemographic and clinical characteristics was collected, and associations between psychiatric illnesses and COPD status were analyzed. The study population was predominantly male (73%), with a mean age of 56.33 years. The COPD assessment score was medium in 65% of participants, with 30% of patients exhibiting high levels. Anxiety was present in 21% of the cohort, while 30% had depression. Analysis revealed a significant association between high COPD scores and increased prevalence of both anxiety and depression (p<0.05). Additionally, patients with a history of pulmonary TB showed higher rates of psychiatric comorbidities. Specifically, anxiety was more prevalent among patients with severe COPD and a history of TB. These findings highlight a substantial burden of anxiety and depression among COPD patients, particularly those with severe disease and a history of TB. These results align with the existing literature, suggesting a strong link between COPD severity, psychiatric comorbidities, and the impact of historical TB on mental health. These insights underscore the need for integrated management strategies addressing both respiratory and psychiatric aspects of COPD care.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543674","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 \"Hematological and clinical profiling of chronic obstructive pulmonary disease: a comprehensive study\".","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.4081/monaldi.2025.3226","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3226","url":null,"abstract":"<p><p>Dear Editor, This is a response to the article \"Hematological and clinical profiling of chronic obstructive pulmonary disease: a comprehensive study\". This observational cross-sectional study of chronic obstructive pulmonary disease patients sheds light on the association between hematological profiles and clinical parameters; however, some elements and techniques warrant additional consideration...</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143525092","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 role of genetics in the prognosis of acute myocarditis: a systematic review and meta-analysis.","authors":"Maria João Tomás, Ana Isabel Pinho, Bernardo Sousa Pinto, Elisabete Martins","doi":"10.4081/monaldi.2025.3231","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3231","url":null,"abstract":"<p><p>Myocarditis is a heterogeneous disease with varying clinical presentations, etiologies, and courses. Apart from environmental factors, genetic factors may also play a role in its pathophysiology. Through a systematic review and meta-analysis, we aimed to characterize the relationship between acute myocarditis (AM), underlying genetic background, and prognosis. We searched on MEDLINE/PubMed and Web of Science for studies reporting clinical outcomes of patients presenting with AM and undergoing genetic testing. The prevalence of a positive genetic test result was 27.3%, with a higher proportion of males (61.3%). Patients with a positive genetic test often had a family history of cardiovascular events (53.3%) and late gadolinium enhancement on cardiac magnetic resonance (81.2%), suggesting that these clinical features may represent a population with a higher burden of genetic background and risk for worse outcomes. The risk of recurrence of AM among patients with a positive genetic test was four times greater than among non-carriers (RR=4.02, p<0.001), and the most frequently observed variants among AM carriers were in the TTN, DSP, PKP2, MYH7, BAG3, RMB20, DSG2, TNNT2, and SCN5A genes. Overall, these findings underscore the need to improve the criteria used for genetic testing in the setting of AM episodes and to identify affected individuals who may benefit from increased surveillance and genetic testing.</p>","PeriodicalId":51593,"journal":{"name":"Monaldi Archives for Chest Disease","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143505925","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":"Prospective assessment of venous thromboembolism in lung cancer patients using a standardized screening protocol.","authors":"Pedro Magalhães Ferreira, Joana Ferreira, Cláudia Freitas, Catarina Sousa, David Araújo, Hélder Novais Bastos, Adriana Magalhães, Maria Gabriela Fernandes","doi":"10.4081/monaldi.2025.3293","DOIUrl":"https://doi.org/10.4081/monaldi.2025.3293","url":null,"abstract":"<p><p>Venous thromboembolism (VTE) is highly prevalent in cancer patients. While its actual incidence remains disparate among studies, specific subpopulations, such as lung cancer patients, might be at an increased risk. We aimed to assess the impact of a screening protocol in determining both the incidence and risk factors for VTE and evaluate the usefulness of predictive biomarkers and risk stratification tools in lung cancer patients. For this purpose, we designed a prospective cohort study including all consecutive, newly diagnosed lung cancer patients between October 2023 and April 2024 in a tertiary center and assessed each patient using a standardized screening protocol. VTE screening included baseline and 3-month reassessment of coagulation tests, D-dimer levels, and imaging (duplex ultrasound of the lower limbs for deep vein thrombosis screening and contrast-enhanced thoracic computed tomography for pulmonary embolism screening). A total of 102 patients were included, of which 16 (15.7%) were diagnosed with VTE. VTE was more frequent in males (p=0.031), patients with COPD (p=0.004), and patients with metastatic disease (p=0.038), particularly those under immunotherapy (p=0.026). Patients with VTE presented a D-dimer concentration more than three times higher at baseline and fivefold the levels observed in non-VTE patients at 3 months (p=0.002). Paired with Khorana scores, D-dimer concentration 4.5 mg/L at 3 months improved the predictive capacity of this VTE risk assessment tool in patients under active treatment. Active VTE screening yielded a significant increase in diagnosis, suggesting the incidence of this complication in newly diagnosed lung cancer patients is underestimated. Risk assessment tools can be enhanced by the addition of D-dimer-based parameters.</p>","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":"143484603","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":"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":"<p><p>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.</p>","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}