Monaldi Archives for Chest Disease 2019-05-25T12:08:31+02:00 Nadia Moscato Open Journal Systems <p><strong>Monaldi Archives for Chest Disease</strong> is an international scientific journal of the <em>Istituti Clinici Scientifici Maugeri</em>, Pavia, Italy, dedicated to the advancement of knowledge in all fields of cardiopulmonary medicine and rehabilitation. <!--It is published in two series: the “Cardiac Rehabilitation and Prevention Series” (volume, even numbers) which, since 2002, is the official journal of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR); and the “Pulmonary Medicine and Rehabilitation Series” (volume, odd numbers).--></p> <p><strong>Monaldi Archives for Chest Disease</strong> publishes original articles, new methodological approaches, reviews, opinions, editorials, position papers on all aspects of cardiac and pulmonary medicine and rehabilitation, and, in addition, provides a forum for the inter-exchange of information, experiences and views on all issues of the cardiology profession, including education. Accordingly, original contributions on nursing, exercise treatment, health psychology, occupational medicine, care of the elderly, health economics and other fields related to the treatment, management, rehabilitation and prevention of cardiac and respiratory disease are welcome.</p> <p><strong>Monaldi Archives for Chest Disease</strong> promotes excellence in the profession of cardiology and pneumology through its commitment to the publication of research, support to continuous education, and encouragement and dissemination of ‘best practice’.</p> <p>This journal does not apply charge for publication to Authors as it is supported by institutional funds.</p> Identification of subclinical cognitive impairment in chronic obstructive pulmonary disease using auditory P300 event related potential 2019-05-25T12:08:31+02:00 Soundariya Krishnamurthy Yuvarajan Sivagnaname Gokul Chandu Gumallapu <p>Adequate cognitive functioning in chronic obstructive pulmonary disease (COPD) patients is essential to understand the nature of the disease, adherence to treatment, and for leading a better quality of life. While cognitive impairment in severe forms of COPD have been well documented, identification of subclinical cognitive impairment in stable COPD patients remains crucial for planning prevention strategies. Hence the present study aimed to study and compare the cognitive function between the COPD patients, and normal individuals. The cognitive function was assessed in 42 stable COPD patients and 42 normal individuals with Mini Mental State Examination (MMSE), and auditory P300 event related potentials. Baseline characteristics and the cognitive parameters were compared between the COPD patients and the normal individuals; a p&lt;0.05 was considered statistically significant. The latency of the P300 waves was significantly (p&lt;0.05) prolonged (304.27±20.73 in COPD, 291.11± 24.53 in normal individuals), and the amplitude (4.36±1.56 in COPD, 5.46±3.12 in normal individuals) was significantly reduced in the COPD patients compared to the normal individuals. MMSE scores were also significantly (p&lt;0.001) different between the COPD patients (26.97±0.89), and the normal individuals (27.80±0.83). Cognition may be affected even at the earlier stages of the disease among the COPD patients, as evident by changes in the P300 values. Auditory P300 event related potential may be used as an adjunct to the routine MMSE examination, as it serves as an effective tool in identifying the cognitive impairment in different stages of COPD. This may help the patients to adopt prevention strategies that help to avoid adverse effects on cognition in future.</p> 2019-05-24T13:17:42+02:00 ##submission.copyrightStatement## Educational level, marital status and sex as social gender discharge determinants in chronic obstructive pulmonary disease exacerbations: a time-to-event analysis 2019-05-24T22:52:40+02:00 Orazio Valerio Giannico Immacolata Ambrosino Francesco Patano Cinzia Germinario Michele Quarto Anna Maria Moretti <p>The aim of this study is to evaluate, in patients hospitalized for COPD exacerbation, how educational level, marital status and sex (social gender indicators) affect the home discharge probability (main effects) and how interact with each other in affecting this probability (effect modification). Data for all patients discharged with a principal diagnosis of COPD with exacerbation (ICD-9 491.21) by Apulian hospitals between 2013 and 2017 were retrieved from the National Hospital Discharge Register Database. A multivariable multi-stratified frailty cox proportional-hazard regression with interaction terms was fitted in order to assess the effect of sex, educational level and marital status on the time-to-event for home discharge through the estimation of hazard ratios. Adjusting for several patient and hospitalization characteristics and for healthcare facilities, low educational level (&lt;8 years of schooling) is associated with a lower probability of being discharged to home in both sexes and in all marital status categories (HR 0.92, 95%CI 0.87-0.97, p=0.0020). Female sex is associated with a lower probability of being discharged to home only in married patients (HR 0.83, 95%CI 0.78-0.88, p&lt;0.0001). Marital status different from married is associated with a lower probability of being discharged to home only in male patients, in particular single patients (HR 0.82, 95%CI 0.74-0.92, p=0.0009), separated or divorced patients (HR 0.71, 95%CI 0.58-0.86, p=0.0005) and widowed patients (HR 0.87, 95%CI 0.80-0.95, p=0.0018). Differently from findings about protective effect of education, the evidence of different effects of sex on home discharge probability among civil statuses and of different effect of civil status among sexes is supposed to be a proxy for social gender health and healthcare inequalities.</p> 2019-05-24T10:08:11+02:00 ##submission.copyrightStatement## Use of the North American Nursing Diagnosis Association taxonomies, Nursing Intervention Classification, Nursing Outcomes Classification and NANDA-NIC-NOC linkage in cardiac rehabilitation 2019-05-24T22:51:14+02:00 Anna Maria Iannicelli Pasquale De Matteo Daniele Vito Elisa Pellecchia Concetta Dodaro Francesco Giallauria Carlo Vigorito <p>This study aims at creating a standardized language for each patient admitted to Cardiac Rehabilitation Unit (CR) by identifying nursing diagnosis, interventions, results/objectives expected and related correlations. The primary outcome was identifying health needs of all patients admitted to CR. The secondary outcomes were the identification of North American Nursing Diagnosis Association -International diagnoses (NANDA-I), of nursing intervention classification (NIC), of nursing outcomes classification (NOC) and their correlation NANDA-NIC-NOC linkage (NNN linkage) in order to define a standardized language for all nursing staff. This is a retrospective study involving a sample of 168 patients discharged from CR. The NANDA-I, the NIC, the NOC and the most frequently used NNN connections were identified and collected by using structured form including the 11 functional models of Marjory Gordon. Data from 76 patients were analyzed (92.1% male; mean age (± SD) 62.7±9 yrs; IQ range: 42-82). The main NANDA-I nursing diagnosis belongs to psychological sphere, but not to physiological domains. The statement NIC has allowed to put into practice actions of health prevention and education. Nursing care documentation and NNN taxonomic language promotes a wide diffusion of nursing discipline culture and significant qualitative improvement of patient’s care, further improving the communication between nurses and other health professionals.</p> 2019-05-21T14:35:23+02:00 ##submission.copyrightStatement## Macro- and microvascular functions in cystic fibrosis adults without cardiovascular risk factors: A case-control study 2019-05-24T22:51:15+02:00 Enrico Vizzardi Edoardo Sciatti Ivano Bonadei Dario S. Cani Elisa Menotti Francesco Prati Lucia Dallapellegrina Marco Metra Marialma Berlendis Piercarlo Poli Rita Padoan <p>Increasing survival from cystic fibrosis show untypical systems involvement, such as cardiocirculatory. In particular, the presence of CFTR in smooth muscle and endothelial cells, systemic inflammation and oxidative stress could explain vascular alterations in these patients. We aimed at noninvasely evaluating macro- and microvascular dysfunction in cystic fibrosis adults without cardiovascular risk factors. Twenty-twoadults affected by cystic fibrosis and 24 healthy volunteers matched for age and sex were enrolled. None had known cardiovascular risk factors. All people underwent blood pressure measurement, microvascular function assessment by EndoPAT-2000 device (calculating RH-PAT index) and macrovascular evaluation by pulse wave velocity (PWV). RH-PAT index was significantly lower in patients than in controls (1.74±0.59 <em>vs</em> 2.33±0.34; p&lt;0.001). Thirteen patients of 22 had a value inferior to the threshold of 1.67 (59.1%), while no controls had (p&lt;0.001). Carotid-femoral PWV did not differ between the two groups (5.2±1.5 m/s <em>vs</em> 5.4±1.1; p=0.9), while brachial-ankle one did (11.0±2.2 m/s <em>vs</em> 10.1±0.8 m/s; p=0.04).Adults patients affected by cystic fibrosis show peripheral endothelial dysfunction, which is the first alteration in atherosclerotic phenomenon. Moreover, arterial stiffness measured by PWV unclearly seems to differ respect of healthy people, perhaps because PWV alterations are typical of above 50 years old people. It is unclear what prognostic role of future developing of atherosclerotic disease these findings could be, but it seems evident that cystic fibrosis directly affects cardiovascular system itself.</p> 2019-05-20T15:21:14+02:00 ##submission.copyrightStatement##