Monaldi Archives for Chest Disease <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> PAGEPress Scientific Publications, Pavia, Italy en-US Monaldi Archives for Chest Disease 1122-0643 <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.<br><br> An Open Access Publication is one that meets the following two conditions:</p> <ol> <li>the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.</li> <li>a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</li> </ol> Atrial mechanical hypofunction after electrical cardioversion of persistent or long-lasting persistent atrial fibrillation: a retrospective cohort study <p>In the present retrospective cohort study, we have evaluated the missed or delayed atrial mechanical recovery in a population of patients with persistent or long-lasting persistent AF who achieved restoration of sinus rhythm on the ECG by electrical cardioversion (ECV). <strong>&nbsp;</strong>The endpoint of our&nbsp;&nbsp; study was&nbsp;&nbsp; the failure to recover the normal mechanics of the left atrium.&nbsp; Inclusion criterion was the persistent or long-lasting persistent atrial fibrillation successfully treated by means of&nbsp; &nbsp;&nbsp;ECV , provided that&nbsp; a pertinent documentation&nbsp; was made available, comprising ECG, conventional 2D echo-color-Doppler and&nbsp;&nbsp; speckle tracking echocardiography(STE)&nbsp; evaluation, with also a STE assessment&nbsp; of the atria at the days 1, 30 and 90 &nbsp;from the ECV freely available within&nbsp; the clinical record&nbsp; of the patient. Out of a total of 80 patients with persistent or long-standing persistent AF, retrospectively enrolled, as many as&nbsp; 22.5% of them did not achieve the normalization of their&nbsp; atrial STE profile, even though they had been converted to sinus rhythm on the ECG by means of ECV.&nbsp; The building of ROC curves allowed us to establish that early measurements of global atrial strain could serve to predict&nbsp; both the risk of failure to recover the atrial mechanical function and the one of AF relapses over a 12 month follow-up. The&nbsp;&nbsp; values of 18% and 17% were also calculated&nbsp; to serve as cut off values, respectively,&nbsp; for the risk&nbsp; of atrial mechanical dysfunction and for the risk of AF&nbsp; relapses over a 12 month follow-up. Failure to recover the atrial reservoir function can accompany a restoration of sinus rhythm on the ECG in patients with long-standing persistent AF. In this case, a serial STE evaluation could be useful to evaluate the atrial hypofunction over time.</p> Renato De Vecchis Andrea Paccone Marco Di Maio ##submission.copyrightStatement## 2019-12-17 2019-12-17 89 3 10.4081/monaldi.2019.1178 Malignant bronchial ulcer with coexistent pulmonary tuberculosis <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> Yuvarajan Sivagnaname Praveen Radhakrishnan Antonius Maria Selvam ##submission.copyrightStatement## 2019-12-03 2019-12-03 89 3 10.4081/monaldi.2019.1037 Obstructive sleep apnoea with co existent Kleine-Levine syndrome in a middle-aged man <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> Gopal Chawla Ram Niwas Naveen Dutt Mukesh Kumar Swamy ##submission.copyrightStatement## 2019-11-26 2019-11-26 89 3 10.4081/monaldi.2019.1163 Scope and new horizons for implementation of m-Health/e-Health services in pulmonology in 2019 <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> Vitaliy Mishlanov Alexander Chuchalin Valeriy Chereshnev Vitalii Poberezhets Michele Vitacca Vera Nevzorova Zaurbek Aisanov Alexander Vizel Igor Shubin Aleksey Nikitin Rustem Zulkarneev Yaroslava Khovaeva ##submission.copyrightStatement## 2019-11-21 2019-11-21 89 3 10.4081/monaldi.2019.1112