Monaldi Archives for Chest Disease 2019-12-13T00:51:14+00:00 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> Malignant bronchial ulcer with coexistent pulmonary tuberculosis 2019-12-13T00:51:12+00:00 Yuvarajan Sivagnaname Praveen Radhakrishnan Antonius Maria Selvam <p>Ulceration in the bronchial mucosa is noted rarely in bronchoscopy. In the past, it was frequently encountered in endobronchial tuberculosis. Deep necrotic bronchial ulcers are seen very rarely in clinical practice. Here we are reporting a first-ever case report of malignant bronchial ulcer presenting as necrotic deep bronchial ulcer, in a 70-year-old male, chronic smoker, who complained of breathlessness for 3 months, cough for 3 months, loss of weight and of appetite for 1 month. Bronchoscopy showed a large necrotic ulcer with dense&nbsp;anthracotic pigmentation which bleeds in touch with forceps. Bronchial washings, brushings, endobronchial biopsy were taken from the ulcer which was suggestive of poorly differentiated bronchogenic carcinoma. TBNA from the mediastinal nodes showed the features of caseous necrosis with granulomatous inflammation. Consequently, with the diagnosis of poorly differentiated carcinoma with pulmonary tuberculosis and COPD, the patient was started on anti-tuberculosis drugs, inhaled bronchodilators and referred to an oncologist for chemotherapy.&nbsp;&nbsp;&nbsp;</p> 2019-12-03T09:34:29+00:00 ##submission.copyrightStatement## Obstructive sleep apnoea with co existent Kleine-Levine syndrome in a middle-aged man 2019-12-13T00:51:13+00:00 Gopal Chawla Ram Niwas Naveen Dutt Mukesh Kumar Swamy <p>Hypersomnia is a symptom which is pathognomonic of patients with Kleine-Levin syndrome (KLS), but the cause of this finding remains undefined. Given the pervasive association between obstructive sleep apnoea (OSA) and excessive daytime sleepiness, there exists the possibility that OSA might contribute to the sleepiness exhibited by these patients. Here we report a middle age man who had excessive daytime sleepiness and diagnosed as OSA after polysomnography. Prescribing of continuous positive airway pressure&nbsp;(CPAP) lead to unmasking of episodes of increased sleepiness and other behavioural features of KLS.</p> 2019-11-26T15:19:00+00:00 ##submission.copyrightStatement## Scope and new horizons for implementation of m-Health/e-Health services in pulmonology in 2019 2019-12-13T00:51:14+00:00 Vitaliy Mishlanov Alexander Chuchalin Valeriy Chereshnev Vitalii Poberezhets Michele Vitacca Vera Nevzorova Zaurbek Aisanov Alexander Vizel Igor Shubin Aleksey Nikitin Rustem Zulkarneev Yaroslava Khovaeva <p>The reason for this review based on the results of many meta- analyses is the great assessed difference in the methods of most studies in e-Health, telemedicine and tele-rehabilitation. It consists of different understanding of new terms, using different hard- and software, including criteria, different methodology of patient’s treatment and its evaluation. This status suggests that first of all m-Health/e-Health requires a unique ontology of terms using and methodology of studies comparing. In this review we try to describe shortly the most significant points of modern e-Health field of medicine. The basic parts include methodology of review formation, tele-communication implementation results, tele-education, interactive questioning, tele-consultation, telemedicine diagnosis, tele-monitoring, rehabilitation and tele-rehabilitation, gamification, acceptability of mobile electronic devices and software in e-Health and planning studies. At the end of the review the new ontological structure of digital medicine is presented.</p> 2019-11-21T14:10:39+00:00 ##submission.copyrightStatement## High thrombotic risk increases adverse clinical events up to 5 years after acute myocardial infarction. A nationwide retrospective cohort study 2019-12-13T00:51:14+00:00 Gian Francesco Mureddu Cesare Greco Stefano Rosato Paola D'Errigo Leonardo De Luca Gabriella Badoni Pompilio Faggiano Fulvia Seccareccia <p>The risk of recurrent events among survivors of acute myocardial infarction (AMI) is understudied. The aim of this analysis was to investigate the role of residual high thrombotic risk (HTR) as a predictor of recurrent in-hospital events after AMI. This retrospective cohort study included 186,646 patients admitted with AMI from 2009 to 2010 in all Italian hospitals who were alive 30 days after the index event. HTR was defined as at least one of the following in the 5 years preceding AMI: previous myocardial infarction, ischemic stroke/other vascular disease, type 2 diabetes mellitus, renal failure. Risk adjustment was performed in all multivariate survival analyses. Rates of major cardiac and cerebrovascular events (MACCE) within the following 5 years were calculated in both patients without fatal readmissions at 30 days and in those free from in-hospital MACCE at 1 year from the index hospitalization. The overall 5-year risk of MACCE was higher in patients with HTR than in those without HTR, in both survivors at 30 days [hazard ratio (HR), 1.49; 95% confidence interval (CI), 1.45-1.52; p&lt;0.0001] and in those free from MACCE at 1 year (HR, 1.46; 95% CI, 1.41-1.51; p&lt;0.0001). The risk of recurrent MACCE increased in the first 18 months after AMI (HR, 1.49) and then remained stable over 5 years. The risk of MACCE after an AMI endures over 5 years in patients with HTR. This is also true for patients who did not have any new cardiovascular event in the first year after an AMI. All patients with HTR should be identified and addressed to intensive preventive care strategies.</p> 2019-11-21T08:25:21+00:00 ##submission.copyrightStatement##