Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace最新文献

{"title":"Immune status in sarcoidosis: one size does not fit all.","authors":"Ilias Papanikolaou,&nbsp;Hidenobu Shigemitsu,&nbsp;Andreas Afthinos","doi":"10.4081/monaldi.2020.1306","DOIUrl":"https://doi.org/10.4081/monaldi.2020.1306","url":null,"abstract":"<p><p>B-cell immunity and immunoglobulins are less commonly affected in sarcoidosis. We aimed to evaluate immune status in sarcoidosis patients. Retrospective chart review of sarcoidosis patients attending a out-patient clinic over 3 months period. Immunoglobulins levels were recorded (A, M, G, E) along with clinical and serological data. They were divided in group A (normal IgG), group B (increased IgG), group C (decreased IgG) and group D (decreased IgG and IgM and/or IgA). Of 50 subjects, 68% were females and 62% of Caucasian origin. 22 (44%) had normal IgG levels, 16 (32%) had increased IgG levels, 10 (20%) had hypogammaglobulinemia and 2 (4%) had combined hypogammaglobulinemia, diagnosed with combined sarcoidosis and common variable immunodeficiency. Decreased IgA values was found in groups C and D. IgE was high in group B. Globulin was increased in group B and decreased in groups C and D. Decreased neutrophils were found in group D (all statistically significant). Correlation analysis showed significant association of angiotensin converting enzyme with IgA and IgM, inverse correlation of IgG with white blood cells and neutrophils, of IgA with globulin and inverse with albumin and of calcium with albumin. Most sarcoidosis patients have normal or increased immunoglobulin levels, that correlate with serum biomarkers of disease activity. Hypogammaglobulinemia may reflect treatment side effects and accompanied by blood leukocytosis. Combined severe immunodeficiency occurs in sarcoidosis.</p>","PeriodicalId":520711,"journal":{"name":"Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2020-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/monaldi.2020.1306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38203406","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 validity of a daytime ambulatory blood pressure to diagnose masked hypertension.","authors":"Abdulhalim Jamal Kinsara,&nbsp;Ayman Hassan Elshiekh,&nbsp;Ahmed Mohamed Abuosa,&nbsp;Domenico Galzerano,&nbsp;Mohammed Burhan Abrar","doi":"10.4081/monaldi.2020.1356","DOIUrl":"https://doi.org/10.4081/monaldi.2020.1356","url":null,"abstract":"<p><p>Masked hypertension (MH) is traditionally diagnosed with 24-hour ambulatory blood pressure monitoring (24-ABPM). This is relatively costly and could cause discomfort during the night. We studied the validity of daytime ABP (DT-ABPM) in young National Guard soldiers and determined the prevalence in comparison to the standard 24-ABPM. A prospective study of 196 soldiers aged 21-50 years, without a history of hypertension or antihypertensive medication use. Each participant was fitted with a 12h-ABPM. Patients were diagnosed with MH if the office blood pressure (OBP) was <140/90 mmHg and the average DT-ABPM was ≥135/85 mmHg. By pairing the average OBP with the 12 h-ABPM, the prevalence of MH was estimated as 18/196 (9.2%), the SBP MH (systolic blood pressure) of 8.2% and the DPB MH (diastolic blood pressure) of 3.1%.  When we compared the daytime prevalence with the 24 h-ABPM, and the average OBP, the prevalence of MH was 29/196 (14.8%). No statistically significant difference was noted (kappa=0.74; 95% CI: 0.59 to 0.88). We conclude that DT-ABPM is a good method and convenient to detect MH, with no statistically significant difference when compared to the 24 h-ABPM. The prevalence of MH in young healthy soldiers was unexpectedly high.</p>","PeriodicalId":520711,"journal":{"name":"Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2020-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/monaldi.2020.1356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38203343","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":"Light sedation or no-sedation in ICU: patient experience matters.","authors":"Saurabh Mittal,&nbsp;Anant Mohan,&nbsp;Karan Madan,&nbsp;Vijay Hadda","doi":"10.4081/monaldi.2020.1401","DOIUrl":"https://doi.org/10.4081/monaldi.2020.1401","url":null,"abstract":"<p><p>Dear Editor, We have been using sedation for a long time in intensive care units for patients on mechanical ventilation. Sedation aims at facilitating the patient's ability to remain comfortably connected to the ventilator and minimize oxygen consumption. The strategies for sedation vary from deep sedation and light sedation to nosedation. For the last two decades, light sedation with daily interruption is being practiced by most ICUs...</p>","PeriodicalId":520711,"journal":{"name":"Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2020-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/monaldi.2020.1401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38203344","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":"Takotsubo cardiomyopathy in the setting of multiple sclerosis: a multifaceted phenomenon with important implications.","authors":"Kenan Yalta,&nbsp;Gokay Taylan,&nbsp;Tulin Yalta,&nbsp;Ertan Yetkin","doi":"10.4081/monaldi.2020.1420","DOIUrl":"https://doi.org/10.4081/monaldi.2020.1420","url":null,"abstract":"<p><p>Dear Editor, Takotsubo cardiomyopathy (TTC) has been universally regarded as a unique form of reversible myocardial dysfunction associated with a variety of emotional and physical stressors. In their recently published elegant article, Dell'Aquila et al. have reported an interesting case of TTC triggered by an exacerbation of relapsing-remitting multiple sclerosis (MS). However, we would like to comment on this interesting case and its particular implications...</p>","PeriodicalId":520711,"journal":{"name":"Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2020-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/monaldi.2020.1420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38203345","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":"Pulmonary Rehabilitation.","authors":"Massimiliano Polastri,&nbsp;Stefano Nava","doi":"10.4081/monaldi.2020.1526","DOIUrl":"https://doi.org/10.4081/monaldi.2020.1526","url":null,"abstract":"<p><p>Commenting on this book is a great privilege and an opportunity to share some emerging aspects regarding the development of pulmonary rehabilitation. Indeed, appreciating the therapeutic value of this modality is possible because of continuous research and tireless commitment of all professionals involved in the care of patients with respiratory diseases and pulmonary-related impairments....</p>","PeriodicalId":520711,"journal":{"name":"Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2020-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/monaldi.2020.1526","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38208622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of lung injury resembling diffuse pulmonary hemorrhage after the first administration of alemtuzumab in a patient with multiple sclerosis. Role of the HRCT.","authors":"Gaia Cipolla,&nbsp;Rosalba Relo,&nbsp;Elisa Pasciuta,&nbsp;Domenica Catalano,&nbsp;Federica Lo Bello,&nbsp;Irene Coppolino,&nbsp;Paolo Ruggeri,&nbsp;Alfio Proietto,&nbsp;Maria Buccafusca,&nbsp;Paola Maria Cutroneo,&nbsp;Gianluca Trifirò,&nbsp;Gaetano Caramori","doi":"10.4081/monaldi.2020.1352","DOIUrl":"https://doi.org/10.4081/monaldi.2020.1352","url":null,"abstract":"<p><p>Diffuse alveolar hemorrhage (DAH) is an acute often life-threatening condition characterized by a variable combination of hemoptysis, dyspnoea, diffuse and bilateral ground glass pulmonary opacities, anemia and hypoxemia, that can be induced by different causes, including several drugs. We report here the case of a 25-year-old woman who has been admitted to our pulmonary clinic for the onset of chest pain, cough and haemoptysis, started one week after her first treatment with alemtuzumab for multiple sclerosis. Computed tomography (CT) scan of the chest at the admission showed diffuse and bilateral ground glass pulmonary opacities. Her symptoms resolved completely without any treatment, after the interruption of alemtuzumab, and CT scan of the chest performed one month later showed total disappearance of the pulmonary opacities.</p>","PeriodicalId":520711,"journal":{"name":"Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2020-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/monaldi.2020.1352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38192915","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":"Severe acute respiratory syndrome coronavirus-2 and pulmonary tuberculosis: convergence can be fatal.","authors":"Abhijeet Singh,&nbsp;Rajendra Prasad,&nbsp;Ayush Gupta,&nbsp;Kamanasish Das,&nbsp;Nikhil Gupta","doi":"10.4081/monaldi.2020.1368","DOIUrl":"https://doi.org/10.4081/monaldi.2020.1368","url":null,"abstract":"<p><p>Disease associated with SARS-CoV-2 also termed as Coronavirus disease 2019 or COVID-19, has become a potential threat to public health by spreading across more than 200 countries worldwide within a short span of time. Tuberculosis (TB) is already existing as unprecedented pandemic worldwide over several years. Both diseases have many overlapping features but there are striking differences too. There is usually chronicity of symptoms in TB as compared to acute or rapid progression in COVID-19. Little evidence exists regarding TB and COVID-19 coinfection. It is anticipated that person with TB either in active, previously treated or latent forms are more at risk of poor outcomes with COVID-19. The relationship between the two diseases is still unclear at present, and more studies are needed to enable analyses of interactions and determinants of outcomes in patients affected by both the diseases. Most of the countries across the world imposed nationwide lockdown to promote social distancing, which is one important preventive measure to mitigate the spread of COVID-19 pandemic. However, it becomes quite challenging to ensure smooth functioning of programmatic services, leading to disruption of routine TB care, leading to transmission of infection. Health authorities should frame polices that can support TB patients by providing diagnostic, management and prevention services without any interruption during this era of ongoing COVID-19 pandemic. Effort should be made to control both the diseases simultaneously and avoid unfavourable outcome in near future.</p>","PeriodicalId":520711,"journal":{"name":"Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/monaldi.2020.1368","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38188130","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":"Diffuse alveolar hemorrhage secondary to plastic fume exposure: A case report.","authors":"Omkar K Choudhari,&nbsp;Umesh Chandra Ojha,&nbsp;Dipti Gothi,&nbsp;Sonam Spalgais,&nbsp;Pratap Singh,&nbsp;Anita Rani","doi":"10.4081/monaldi.2020.1304","DOIUrl":"https://doi.org/10.4081/monaldi.2020.1304","url":null,"abstract":"<p><p>A 31-year non-smoker man, working in plastic making industry for 12 years presented with cough and streaking hemoptysis for 2 days. Computed tomography (CT) of chest showed patchy ground glass opacities with interlobular septal thickening in bilateral lung parenchyma. Fiber optic bronchoscopy (FOB) was done. Sequential lavage was taken which showed progressively increasing hemorrhagic fluid. His diffusion capacity for carbon monoxide (DLCO) was 38.08 mL/mmHg/Mi (126%) predicted on day 2 of admission, 32.36 ml/mmHg/Mi (106%) predicted on discharge and 39.63 mL/mmHg/Mi (130%) predicted on going back to work. He was diagnosed with plastic fume exposure related pulmonary alveolar hemorrhage.</p>","PeriodicalId":520711,"journal":{"name":"Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/monaldi.2020.1304","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38178726","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":"Early trends of socio-economic and health indicators influencing case fatality rate of COVID-19 pandemic.","authors":"Shahir Asfahan,&nbsp;Aneesa Shahul,&nbsp;Gopal Chawla,&nbsp;Naveen Dutt,&nbsp;Ram Niwas,&nbsp;Neeraj Gupta","doi":"10.4081/monaldi.2020.1388","DOIUrl":"https://doi.org/10.4081/monaldi.2020.1388","url":null,"abstract":"<p><p>Coronavirus disease 2019, i.e. COVID-19, started as an outbreak in a district of China and has engulfed the world in a matter of 3 months. It is posing a serious health and economic challenge worldwide. However, case fatality rates (CFRs) have varied amongst various countries ranging from 0 to 8.91%. We have evaluated the effect of selected socio-economic and health indicators to explain this variation in CFR. Countries reporting a minimum of 50 cases as on 14th March 2020, were selected for this analysis. Data about the socio-economic indicators of each country was accessed from the World bank database and data about the health indicators were accessed from the World Health Organisation (WHO) database. Various socioeconomic indicators and health indicators were selected for this analysis. After selecting from univariate analysis, the indicators with the maximum correlation were used to build a model using multiple variable linear regression with a forward selection of variables and using adjusted R-squared score as the metric. We found univariate regression results were significant for GDP (Gross Domestic Product) per capita, POD 30/70 (Probability Of Dying Between Age 30 And Exact Age 70 From Any of Cardiovascular Disease, Cancer, Diabetes or Chronic Respiratory Disease), HCI (Human Capital Index), GNI(Gross National Income) per capita, life expectancy, medical doctors per 10000 population, as these parameters negatively corelated with CFR (rho = -0.48 to -0.38 , p<0.05). Case fatality rate was regressed using ordinary least squares (OLS) against the socio-economic and health indicators. The indicators in the final model were GDP per capita, POD 30/70, HCI, life expectancy, medical doctors per 10,000, median age, current health expenditure per capita, number of confirmed cases and population in millions. The adjusted R-squared score was 0.306. Developing countries with a poor economy are especially vulnerable in terms of COVID-19 mortality and underscore the need to have a global policy to deal with this on-going pandemic. These trends largely confirm that the toll from COVID-19 will be worse in countries ill-equipped to deal with it. These analyses of epidemiological data are need of time as apart from increasing situational awareness, it guides us in taking informed interventions and helps policy-making to tackle this pandemic.</p>","PeriodicalId":520711,"journal":{"name":"Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2020-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/monaldi.2020.1388","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38178727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case report on expanding horizon of endobronchial ultrasound through esophagus.","authors":"Mario Tamburrini,&nbsp;Parikshit Thakare,&nbsp;Francesca Zampieri,&nbsp;Angelo Scarda,&nbsp;Alessandra Di Paolo,&nbsp;Giancarlo De Leo,&nbsp;Enrico Gianfagna,&nbsp;Lucia Vietri,&nbsp;Umberto Zuccon","doi":"10.4081/monaldi.2020.1274","DOIUrl":"https://doi.org/10.4081/monaldi.2020.1274","url":null,"abstract":"<p><p>Endobronchial ultrasound has revolutionized the field of bronchoscopy and has become one of the most important tools for the diagnosis of intrathoracic lymphadenopathy and para-bronchial structures. The reach of this technique has not been limited to these structures and pleural lesions have been at times accessible. To our knowledge, pleural fluid collections have not been accessed with endobronchial ultrasound (EBUS) through oesophageal approach and rationale behind using this approach. We report a case of 70 years old man who has been referred from physician for the EBUS in view of hilar mass with mediastinal lymphadenopathy with pleural effusion. The endobronchial ultrasound through oesophagus (EUS-B) was done for thoracocentesis and lymph node cytology evaluation and ultimately endobronchial biopsy of hilar mass was done as rapid on-site (ROSE) analysis of lymph node was suggestive of necrotic tissue. The cytology report of lymph node and pleural effusion was positive for malignant cells. The final diagnosis was metastatic poorly differentiating adeno-squamous carcinoma.</p>","PeriodicalId":520711,"journal":{"name":"Monaldi archives for chest disease = Archivio Monaldi per le malattie del torace","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2020-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4081/monaldi.2020.1274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38178725","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}