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Monaldi Arch Chest Dis 2018 12 12;88(3):999. Epub 2018 Dec 12.

San Raffaele Scientific Institute, Department of Thoracic Surgery.

Transbronchial needle aspiration under endobronchial ultrasound guidance (EBUS-TBNA) is recommended for the diagnosis and staging of lung cancer. Major complications following EBUS-TBNA are uncommon. We report a case of isolated tension pneumoperitoneum following EBUS-TBNA under deep sedation in an 80-year-old male patient affected by a right hilar mass suspicious for lung cancer. Read More

Monaldi Arch Chest Dis 2018 11 6;88(3):981. Epub 2018 Nov 6.

Istanbul University, Cerrahpasa Medical Faculty, Pulmonary Diseases Department.

A 64-year-old female was admitted for dry cough, dyspnea, fever, loss of appetite, and weight loss. Past medical history revealed scoliosis, cholecystectomy, and Hodgkin lymphoma. ABG values were: pH: 7. Read More

Monaldi Arch Chest Dis 2018 10 1;88(3):982. Epub 2018 Oct 1.

CTO Hospital, Emergency Department.

Cardiogenic pulmonary edema is a common presentation of acute heart failure normally treated with continuous positive airway pressure (CPAP), diuretics and nitrates. This therapy is contraindicated in case of cardiac tamponade. We describe a case of pulmonary edema due to cardiac tamponade in which integrated lung-heart ultrasound examination allowed prompt diagnosis and pericardiocentesis before administration of CPAP thus avoiding circulatory collapse. Read More

Monaldi Arch Chest Dis 2018 10 3;88(3):967. Epub 2018 Oct 3.

Hospital of Vittorio Veneto, Pulmonary Diseases Unit.

The sedation plays an important role in the endobronchial ultrasound transbronchial needle aspiration (EBUS-TBNA) procedure. The sedation can be Minimal (anxiolysis), Moderate (conscious sedation) or Deep. The ACCP guidelines suggest that moderate or deep sedation (DS) is an acceptable approach. Read More

Monaldi Arch Chest Dis 2018 10 11;88(3):988. Epub 2018 Oct 11.

IRCCS SDN, Naples.

Heart Failure (HF) is a major healthcare issue, given its high prevalence and incidence, the rate of comorbidities, the related high health-care costs and its poor outcome. In the last years mounting evidence revealed several differences between men and women affected by this clinical condition. Apart from the well-known difference in phenotype (HF with reduced ejection fraction (HFrEF) occurs more commonly in men, and HF with preserved ejection fraction (HFpEF) is more frequent in women) other relevant sex-related issues dwell upon epidemiology, presentation, risk stratification and management. Read More

Monaldi Arch Chest Dis 2018 10 26;88(3):1004. Epub 2018 Oct 26.

U.O. Cardiologia Riabilitativa, Dipartimento di Cardioangiologia Riabilitativa, Istituti Clinici Scientifici Maugeri, IRCCS di Pavia.

Cardiac rehabilitation (CR) is the subspecialty of clinical cardiology dedicated to the treatment of cardiac patients, early and in the long term after an acute event. The aim of CR is to improve both quality of life and prognosis through prognostic stratification, clinical stabilization and optimization of therapy (pharmacological and non), management of comorbidities, treatment of disability, as well as through the provision and reinforcement of secondary prevention interventions and maintenaince of adherence to treatment. The mission of CR has changed over time. Read More

Monaldi Arch Chest Dis 2018 10 30;88(3):974. Epub 2018 Oct 30.

University of Padua, Department of Cardiologic, Thoracic and Vascular Sciences.

We report a case of the repair of an acquired benign tracheoesophageal fistula (TEF) after prolonged mechanical invasive ventilation. Patient had an unknown double incomplete aortic arch determining a vascular ring above trachea and esophagus. External tracheobronchial compression, caused by the vascular ring, increasing the internal tracheoesophageal walls pressure determined by endotracheal and nasogastric tubes favored an early TEF development. Read More

Monaldi Arch Chest Dis 2018 09 7;88(3):922. Epub 2018 Sep 7.

Grantham Hospital, TB and Chest Unit.

Two ladies with history of carcinoma of tongue presenting with un-resolving pneumonia were ultimately diagnosed to have lipoid pneumonia, and both were subsequently found to be associated with the practice of oil pulling which is a popular complementary therapy. Apart from cessation of oil pulling, they were treated with repeated therapeutic lobar broncho-alveolar lavage. despite the potential benefits of oil pulling on oral health, people especially those at risk of aspiration, should be properly informed of this potential risk when considering this form of complementary therapy. Read More

Monaldi Arch Chest Dis 2018 09 7;88(3):969. Epub 2018 Sep 7.

-"Sapienza" University, Department of Cardiovascular, Respiratory, Nephrological, Anesthetic and Geriatric Sciences -Policlinico Casilino, Department of Cardiology.

Takotsubo cardiomyopathy (TCM) is characterized by transient ventricular dysfunction, classically in its apical and mid segments, in the absence of coronary lesions, and is often observed after intense stressful events and occasionally associated to an acute medical illness. We describe a case of TCM associated with coronary artery disease and triggered by a percutaneous coronary angioplasty. This case highlights the concept that a medical procedure can lead, in certain conditions, to TCM and provides new interesting insights on the pathophysiology of coronary syndromes. Read More

Monaldi Arch Chest Dis 2018 09 11;88(3):944. Epub 2018 Sep 11.

Istanbul University, Cerrahpasa Medical Faculty, Pulmonary Diseases Department.

The sensitivity and specificity of exfoliative cell cytology for the diagnosis of exudative pleural effusions varies widely according to the etiologic causes. The aim of this study is to assess the diagnostic value of exfoliative cell cytology for the identification of exudative pleural effusions. This is a retrospective study of the patients with an exudative pleural effusion admitted at our clinic in the last twenty years. Read More

Monaldi Arch Chest Dis 2018 09 6;88(3):987. Epub 2018 Sep 6.

Federico II University of Naples, Department of Translational Medical Sciences.

Exercise training (ET) is strongly recommended in patients with chronic stable heart failure (HF). Moderate-intensity aerobic continuous ET is the best established training modality in HF patients. In the last decade, however, high-intensity interval exercise training (HIIT) has aroused considerable interest in cardiac rehabilitation community. Read More

Monaldi Arch Chest Dis 2018 09 4;88(3):913. Epub 2018 Sep 4.

Athens Naval and Veterans Hospital, Department of Thoracic Surgery.

The familial occurrence of thymic pathology, even though rare, is widely reported in the literature and mainly concerns cases of familial autoimmune myasthenia gravis. Other less frequent cases of familial occurrence of thymoma, thymic carcinoid and thymic hyperplasia have been described. It seems that the familial occurrence is poorly recorded and thus its prevalence is underestimated. Read More

Monaldi Arch Chest Dis 2018 09 4;88(3):927. Epub 2018 Sep 4.

Monaldi Hospital, Adult Congenital Heart Disease Unit.

Transvenous pacemaker (PM) catheters can be unintentionally placed in the left ventricle (LV) during the implantation procedure. An 8-year-old girl was discovered with a malpositioned pm wire, seven years after the implant. Trans-thoracic echocardiogram revealed the lead traversing the inter-atrial septum, crossing the mitral valve and embedded in the basal lateral wall of the LV. Read More

Monaldi Arch Chest Dis 2018 09 4;88(3):906. Epub 2018 Sep 4.

King Faisal Specialist Hospital & Research Center, Heart Center.

We describe a case of a left atrial myxoma atypical for its anatomical features and site of attachment. Although an initial multimodality imaging was performed, the diagnosis of myxoma was possible only by three dimensional echocardiography (3DE) which was able to identify the pedicle and the attachment at the base of the interatrial septum, close to the origin of right inferior pulmonary vein. In fact the 3DE can electronically section the structures and obtain unique planes useful in visualizing correctly the anatomical features of the myxomas and as a result, it facilitates the surgical decision planning. Read More

Monaldi Arch Chest Dis 2018 09 5;88(3):989. Epub 2018 Sep 5.

Federico II University of Naples, Department of Translational Medical Sciences.

Heart failure (HF) is a disease characterized by increasing prevalence, huge direct and indirect costs, and an ominous prognosis, worse than many cancers. At the beginning of the 90s, growth hormone (GH) was proposed as potential adjunctive therapy in HF mostly due to its growth-promoting, vasodilating, and anti-apoptotic actions. However, although several uncontrolled clinical studies showed that GH therapy improved several cardiovascular parameters, two robust trials failed to confirm these findings. Read More

Monaldi Arch Chest Dis 2018 09 5;88(3):975. Epub 2018 Sep 5.

Federico II University of Naples, Department of Translational Medical Sciences.

Hormonal abnormalities are quite common in chronic heart failure (CHF). The most studied hormonal axis in CHF is the impairment of Growth Hormone (GH)/Insulin Growth Factor-1(IGF-1), which in turn is defined either by a blunted response to GH stimulation test or low serum IGF-1 values.  Several independent groups reported that the presence of an abnormal GH/IGF-1 status in CHF is associated with a more severe disease, impaired functional capacity and reduced Survival rates. Read More

Monaldi Arch Chest Dis 2018 09 5;88(3):976. Epub 2018 Sep 5.

IRCCS SDN Naples.

Mounting evidence suggests that hormonal deficiencies (HD) have an important role in chronic heart failure (CHF). In particular, androgen depletion is common in men with CHF and is associated with increased morbidity and mortality. This review summarizes the current understanding of the complex relationship between CHF and testosterone, focusing on evidence derived from clinical trials that have investigated the role of testosterone in the treatment of CHF. Read More

Monaldi Arch Chest Dis 2018 09 4;88(3):970. Epub 2018 Sep 4.

University of Milan Bicocca, Dipartimento Cardio-Toraco-Vascolare.

Patients with Interstitial Lung Disease (ILD) without a definitive diagnosis of connective tissue diseases (CTD) were historically described as Undifferentiated Connective Tissue Disease (UCTD-ILD). Recently a new classification, Interstitial Pneumonia with Autoimmune Features (IPAF), has been proposed. Aim of this study was to describe the prevalence, clinical characteristics and prognostic factors of UCTD and IPAF subjects in a cohort of Non-Specific Interstitial Pneumonia (NSIP) patients. Read More

Monaldi Arch Chest Dis 2018 09 4;88(3):901. Epub 2018 Sep 4.

Invasive Cardiology Unit, Pineta Grande Hospital.

The use of medical devices is constantly growing and constitutes a valid aid to ailing people because of remarkable technological advances. The regulations on their circulation in Italy and Europe are inspired by the principle of free circulation: it is sufficient for a device to have the CE logo for it to be freely commercialized in all European countries. These regulations that favors commerce also expose the sick to the risk of harm from defective devices that have not been suitably checked prior to commercial release. Read More

Monaldi Arch Chest Dis 2018 09 4;88(3):934. Epub 2018 Sep 4.

University of Brescia, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health.

Psoriasis is a systemic inflammatory disease with a great prevalence in general population. The inappropriate activation of the cellular immune system has been hypothesized to be an independent cardiovascular risk factor, given the higher incidence of cardiovascular disorders in psoriatic patients. Echocardiographic abnormalities have been demonstrated too: the aim of our study was to evaluate the presence of preclinical cardiac dysfunction in a cohort of psoriatic patients without cardiovascular risk factors. Read More

Monaldi Arch Chest Dis 2018 07 5;88(2):919. Epub 2018 Jul 5.

"S.G. Moscati" National Hospital - Avellino, Italy.

In patients with chronic heart failure (HF), it is unclear whether self-evaluation of HF-related symptoms and signs may contribute to the surveillance of clinical stability over time or the early identification of worsening HF.   Therefore, HF-related symptoms and signs, and compliance to therapy were investigated by a self-administrated questionnaire in patients hospitalized due to worsening HF (cases) as well in those with stable HF (controls).  The temporal interval of interest for the questionnaire focused on 2 to 7 days before the hospitalization of the control visit. Read More

Monaldi Arch Chest Dis 2018 Jul 2;88(2):914. Epub 2018 Jul 2.

Ahvaz Jundishapur University of Medical Sciences, Alimentary Tract Research Center.

The presence of increased air bubble in the lumina of esophagus on a chest CT scan may be associated with esophageal disorders. The purpose of this study was to determine the association between the appearance of air bubbles on chest CT scan and gastroesophageal Reflux Disease (GERD). In this case-control study, thirty-two patients with endoscopically proved GERD and 32 subjects without GERD underwent chest computed tomography (CT) scanning. Read More

Monaldi Arch Chest Dis 2018 Jul 2;88(2):966. Epub 2018 Jul 2.

Istituti Clinici Scientifici Maugeri IRCCS Milan, Psychology Unit.

Recent guidelines on cardiovascular disease prevention suggest multimodal behavioral interventions for psychosocial risk factors and referral for psychotherapy in the case of clinically significant symptoms of depression and anxiety overall. Accordingly, psychologists of the Italian Association for Cardiovascular Prevention, Rehabilitation and Epidemiology (GICR-IACPR) have reviewed the key components of psychological activities in cardiovascular prevention and rehabilitation (CPR). The aim of this study was to elaborate a position paper on the best practice in routine psychological activities in CPR based on efficacy, effectiveness and sustainability. Read More

Monaldi Arch Chest Dis 2018 Jun 25;88(2):928. Epub 2018 Jun 25.

Vardhaman Mahavir Medical College and Safdarjung Hospital.

Endobronchial ultrasound (EBUS) features have been shown to be useful in predicting etiology of enlarged malignant lymph nodes. However, there is dearth of evidence especially from developing countries. We assessed the EBUS characteristics across various mediastinal and hilar lymphadenopathies. Read More

Monaldi Arch Chest Dis 2018 Jun 22;88(2):909. Epub 2018 Jun 22.

IRCCS Ospedale Policlinico San Martino, University of Genoa, Pulmonology Division.

Pneumomediastinum is defined as the presence of air or gas within the mediastinum and it rarely complicates bronchoscopy. We report, to our best knowledge, the first case of pneumomediastinum following a transbronchial cryobiopsy (TBLC). TBLC is considered a safe procedure as compared with both transbronchial biopsy and surgical lung biopsy. Read More

Monaldi Arch Chest Dis 2018 Jun 22;88(2):915. Epub 2018 Jun 22.

North Bristol NHS Trust, North Bristol Lung Centre, Southmead Hospital.

EBUS-TBNA is a recent mediastinal staging and diagnostic technique. We have previously reported superior characterisation with 21G biopsies over 22G biopsies for benign and malignant mediastinal nodes. A new 19G needle now exists but there are limited studies. Read More

Monaldi Arch Chest Dis 2018 Jun 21;88(2):897. Epub 2018 Jun 21.

Akashi Medical Center, Department of General Internal Medicine.

We describe a case of microscopic polyangiitis manifested as pleuritis confirmed by thoracoscopic biopsy. An 80-year-old man presented with a three-day history of shortness of breath and cough. Chest radiography revealed patchy opacities in the lower fields of the bilateral lung and right-sided pleural effusion. Read More

Monaldi Arch Chest Dis 2018 Jun 21;88(2):917. Epub 2018 Jun 21.

University Hospital Careggi, Department of Clinical and Experimental Biomedical Sciences.

Patients treated for lung cancer may develop lung toxicity induced by chemotherapy (DILD), radiation or combined radiation recall pneumonitis. In the literature, some cases of immune-mediated pneumonitis have been reported associated with immunotherapy. The clinical and radiologic features of interstitial lung toxicity are unspecific, dyspnoea and dry cough are the most common symptoms while the most frequent radiological pattern is the cryptogenic organizing pneumonia (COP). Read More

Monaldi Arch Chest Dis 2018 May 14;88(1):907. Epub 2018 May 14.

University of Milan Bicocca, San Gerardo Hospital, Respiratory Unit.

Primary lung lymphoma (PLL) is a rare type of lymphoma confined to the lung at the time of diagnosis. Pulmonary diffuse large B cells lymphoma (P-DLBCL) is the second most common type of PLL and it usually appears radiologically as solitary or multiple nodules or areas of consolidation. We present the case of a 63-year-old Caucasian male who developed severe acute respiratory failure and diffuse ground glass opacities (GGO) on chest computerized tomography. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):960. Epub 2018 Jun 7.

Academic Unit of Internal Medicine and Hypertension Centre, University of Catania, Cannizzaro Hospital.

Despite the effectiveness of anti-hypertensive therapy is well recognized, the most adequate target to achieve in the management of hypertension in the elderly is still under debate. Indeed, looking at the balance between benefits and risks, accumulating evidence has recently specifically addressed this issue, focusing on controversies. Evidence surrounding a more aggressive treatment may lead to a turnaround in the clinical care of older adult hypertensives, but a balanced trade-off between benefits and risks needs to be programmed and achieved, particularly in this clinical setting. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):959. Epub 2018 Jun 7.

Spedali Civili, Cardiology Division.

Stroke is the second largest cause of European cardiovascular and total mortality, largely due to atherosclerotic carotid artery narrowing or thromboembolism consequent to internal carotid artery stenosis. Current therapeutic indications suggest lifestyle interventions (smoking cessation, healthy diet and physical activity), adequate control of LDL-cholesterol and glycemic balance. It is nonetheless established that the most important factors in preventing stroke are antiplatelet therapy and blood pressure regulation. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):953. Epub 2018 Jun 7.

Italian Association for Cardiovascular Prevention and Rehabilitation, Department of Internal Medicine, San Giovanni-Addolorata Hospital.

The concept that 'the lower the blood pressure (BP) achieved the better the outcome' rests on the demonstration of a direct relationship between BP and incident outcomes, down to levels of 115 mmHg of systolic BP (sBP) and 75 mmHg of diastolic BP (dBP) carried out in 1 million individuals from 61 cohorts recruited between 1950 and 1990 and followed for about 14 years. The alternative to the 'lower the better' concept is the hypothesis of a J-shaped relationship, according to which the benefits of reducing sBP or dBP to low values may be dangerous leading even to an increase in total mortality and/or in CV outcomes. Data from contemporary epidemiologic observations,  (CALIBER study), showed that the relationships between rising BP  and increased incidence of outcomes rise continuous even over 85 years of age without the evidence of a  J-shaped  association  with  any  of  the  outcomes at any age strata. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):971. Epub 2018 Jun 7.

Istituti Clinici Scientifici Maugeri IRCCS.

Some observational studies raised questions about the need for β-blockers in all patients after a first heart attack. Surprisingly, in some clinical settings, a limited mortality reduction was found in those who received β-blockade.Some studies suggest that patients without heart failure may not need post-MI β-blockers. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):957. Epub 2018 Jun 7.

University of Florence, Department of Experimental and Clinical Medicine.

Atrial fibrillation (AF) and coronary artery disease requiring percutaneous coronary intervention (PCI) and stenting often coexist in older patients. This poses the difficult problem of concurrent anticoagulant and double antiplatelet therapy (triple therapy). Current treatment guidelines do recommend triple therapy, especially in the course of acute coronary syndrome (ACS), with limitations due to an excessive risk of bleeding associated with this therapeutic regimen. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):952. Epub 2018 Jun 7.

"Sapienza" University of Rome, Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences.

Dual antiplatelet therapy (DAPT) is an important strategy for reducing cardiovascular events (CV) after an acute coronary syndrome (ACS). Elderly patients undergoing DAPT have a higher risk of bleeding than younger patients for a variety of reasons. Stratification of thrombotic/hemorrhagic risk is mandatory in order to decide on the type and duration of DAPT. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):961. Epub 2018 Jun 7.

Hospital S. Giovanni-Addolorata, Unit of Geriatrics.

Old age remains one of the strongest risk factors for stroke in patients with atrial fibrillation (AF). Oral anticoagulation (OAC) is the most effective way to prevent thromboembolic disease in patients with atrial fibrillation (AF). Until few years ago, aspirin and vitamin-K antagonists (VKAs) were the primary agents used to prevent thromboembolic disease in patients with AF. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):955. Epub 2018 Jun 7.

University of Florence, AOU Careggi, Geriatric Intensive Care Unit and Geriatric Arrhythmia Unit.

Atrial fibrillation (AF) is the most frequent arrhythmia in elderly people. Findings derived from clinical trials seem to demonstrate that a rate-control strategy of AF in aged patients improves prognosis if compared to a rhythm-control one. However, epidemiological studies concordantly show that the arrhythmia is associated to increased hospitalization and mortality rates. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):954. Epub 2018 Jun 7.

ICS Maugeri, IRCCS Montescano, Department of Cardiology.

Digoxin use remains a common therapeutic option in the pharmacological control of heart rate in patients with atrial fibrillation, endorsed in current guidelines with the same level of evidence than beta-blockers in patients with and without heart failure. Digoxin has a narrow therapeutic range and is influenced by drug-to-drug interactions, serum electrolyte concentrations, and renal function. Conflicting data exist regarding adverse outcomes that are associated with digoxin use in patients with atrial fibrillation. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):956. Epub 2018 Jun 7.

S. Eugenio Asl Roma 2 Hospital, "Transmurale" Geriatric Unit.

Atrial fibrillation represents one of the most significant aging markers and its prevalence increases with age, reaching 11.1% in men and 9.1% in women aged over 85 years. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):949. Epub 2018 Jun 7.

ASST Rhodense, Clinical Electrophysiology Unit.

Atrial fibrillation (AF) is a relevant cardiovascular condition that is more prevalent in the elderly patients aged over 65 years. AF, with abnormal rate and rhythm can cause symptoms directly or indirectly by exacerbating other frequently coexisting cardiac conditions such as valvular heart disease, hypertension, ischemic cardiomyopathy, dilated cardiomyopathy, and hypertrophic cardiomyopathy. Evidence suggests that aging-related cardiovascular changes predispose to the elderly to AF. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):958. Epub 2018 Jun 7.

Campus Bio-Medico University of Rome.

Antithrombotic treatment of frail patients with AF presents various challenges. The fear of bleeding often leds to a large underuse of anticoagulant agents in these patients, although more recent data indicate that oral anticoagulation  (especially with the newer, direct anticoagulants) is increasingly used. While there is a need for more real world data, available evidence suggests that non-vitamin K antagonist oral anticoagulants (NOACs) are an effective alternative to warfarin in frail patients with AF for preventing thromboembolic events, with a better safety profile. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):951. Epub 2018 Jun 7.

University Hospital "Paolo Giaccone", Department of emerging diseases and of continuity of care.

Heart failure, in its diverse forms based on the value of the ejection fraction, is associated to high mortality and the frequent need for hospitalization, with a consequent heavy burden on healthcare resources. For an appropriate treatment of heart failure with preserved ejection fraction (HFpEF), there are no specific drugs effective for this condition. Those indicated in HF with reduced EF (HFrEF) are of more benefit in that form of HF, according to the guidelines of the European Society of Cardiology of 2016: ACE-inhibitors, beta-blockers, anti-aldosterones are all indicated with a class of recommendation/level of evidence IA; therapy with loop diuretics is indicated in the case of clinical congestion (IB). Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):950. Epub 2018 Jun 7.

Roccadaspide Hospital, Cardiology Department.

One of the potential cardiotoxic action of anti-inflammatory drugs is the occurrence of heart failure (HF), due to their effects on fluid retention and blood pressure. The risk of hospitalization for HF is roughly doubled for both Coxibs, cyclooxygenase-1 (COX-1) and cyclooxygenase- 2 (COX-2) inhibitors, and all the conventional nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs are also associated with a risk of vascular thrombosis, which for NSAIDs is different in relation to their different ability to inhibit COX-1 and COX-2. Read More

Monaldi Arch Chest Dis 2018 Jun 7;88(2):948. Epub 2018 Jun 7.

Azienda ospedaliera G. Brotzu.

With improved health care and with population aging, heart failure (HF) has become a common disease among the elderly and is one of the principal causes of mortality in elderly age. But the pharmacological management of HF in the elderly has still not yet been defined, as the clinical context is complicated by comorbidities, and differs from that of younger adults. In general, elderly patients with HF should be treated according to current guideline recommendations, for which ACE-I, beta-blockers and anti-aldosterones constitute the cornerstone of therapy. Read More

Monaldi Arch Chest Dis 2018 May 28;88(1):912. Epub 2018 May 28.

Athens Naval and Veterans Hospital, Department of Thoracic Surgery.

Breast reconstruction is a very popular surgical intervention performed either for cosmetic reasons or after oncological resections. Even though silicone is considered to be an inert material, there are side effects that have been reported, such as silicone lymphadenopathy. In the case reported herein, a silicone lymphadenopathy of the internal mammary and the anterior mediastinal lymph nodes were revealed after a thymectomy for autoimmune myasthenia gravis. Read More

Monaldi Arch Chest Dis 2018 May 28;88(1):931. Epub 2018 May 28.

ASST Fatebenefratelli Sacco, Department of Internal Medicine.

Tubercular sternal osteomyelitis is a rare manifestation of tuberculosis. We describe the case of a 51-years-old male patient, presenting with three months history of pain and swelling of the central chest wall, referred to our hospital with clinical diagnosis of chondrosarcoma of the sternum. Read More

Monaldi Arch Chest Dis 2018 Apr 30;88(1):910. Epub 2018 Apr 30.

Internal Medicine Department, Cerrahpasa Medical Faculty, Istanbul University.

The main objective of this study was to evaluate the influence of muscle involvement on the clinical features, prognostic outcome, extrapulmonary organ, and endobronchial involvement in sarcoidosis patients. The second aim was to assess the diagnostic yield of muscle biopsy for the histopathologic identification of sarcoidosis.  Fifty sarcoidosis patients participated in the study. Read More

Monaldi Arch Chest Dis 2018 Apr 30;88(1):905. Epub 2018 Apr 30.

401 Hellenic Army Hospital, Joint Corps Armed Forces Cardiac Surgery Department.

Myxomas are the most common benign cardiac tumors and are located more frequently in the left atrium. In the literature there are cases describing the coexistence of thymic tumors and cardiac myxomas. In the case reported herein, during the resection of a cardiac myxoma, an enlarged thymus gland was encountered and resected. Read More

Monaldi Arch Chest Dis 2018 Mar 23;88(1):903. Epub 2018 Mar 23.

Ahvaz Jundishapur University of Medical Sciences.

Arsenic is a common environmental and occupational contaminant worldwide which can influence the development of respiratory diseases. In recent years, alteration in the lifestyle as well as food habits have led to increased consumption of food containing high levels of fat. The present study was designed to evaluate the effects of chronic exposure to a high-fat diet (HFD) on arsenic-induced damages and oxidative stress in the lung tissue of mice. Read More

Monaldi Arch Chest Dis 2018 May 9;88(1):888. Epub 2018 May 9.

Santo Stefano Institute, Pulmonology Rehabilitation Unit, Hospital of Casorate Primo.

Nosocomial or hospital acquired pneumonia (HAP) is an illness contracted during a hospital stay, generally with onset 48 hours or more after admission to hospital, or within 14 days of discharge from hospital. HAP is divided into subgroups: Ventilator-associated pneumonia (VAP), accounting for 86% of hospital acquired pneumonia, and stroke-associated pneumonia (SAP). The incidence of SAP in neurological intensive care units (NICUs) is 4. Read More