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 class="show">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 class="show">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 class="show">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 class="show">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 class="show">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> The brain-heart connection: a multiple sclerosis relapse presenting as Takotsubo Syndrome. A case report and literature review <p>We hereby report a puzzling case of multiple sclerosis (MS) relapse presenting as Takotsubo syndrome (TTS). Female, 42-years old, who presented herself to the Emergency Room of University Hospital “ASST Spedali Civili” of Brescia, Italy, for a severe headache and a non-ST-segment elevation acute coronary syndrome. Coronary angiogram showed no signs of coronary atherosclerosis. Upon further neurological evaluation, a diagnosis of MS relapse, related to TTS, was made, and treatment was started accordingly. The patient was discharged after 12 days after the admission, free of symptoms, and without signs of neurological and cardiological active disease. A hallmark of TTS is its association with a preceding stressful event. It may also be connected to a wide variety of diseases, including neurological ones, such as stroke, intracranial bleeding, head trauma, migraine, and seizures. However, up to our knowledge, only few cases of MS-induced TTS were previously described. Whether it is plausible to consider TTS as an uncommon extra-neurological manifestation of MS is still debated, however all the evidence points in that direction, considering the central role of catecholamines in TTS pathogenesis. With this case report the authors hope to encourage research on this field and on the intricate topic of brain-heart connections.</p> Andrea Dell'Aquila Edoardo Sciatti Enrico Vizzardi Marco Metra Copyright (c) 2020 The Author(s) 2020-04-02 2020-04-02 90 1 10.4081/monaldi.2020.1153 Chloroquine in COVID-19: the evidence <p><strong>To the Editor</strong><br>The Coronavirus disease 2019 (COVID-19) has been declared as a pandemic by World Health Organisation (WHO). The global mortality has increased, especially in countries like Italy and Iran. With the increasing morbidity and mortality, search for a cure has been the global demand.</p> Nitesh Gupta Sumita Agrawal Pranav Ish Copyright (c) 2020 The Author(s) 2020-03-31 2020-03-31 90 1 10.4081/monaldi.2020.1290 Emerging prophylaxis strategies against COVID-19 <p>The Novel corona virus 2019 which started as an outbreak in China in December 2019 has rapidly spread all over the world, such that on 11th March 2020 WHO declared this disease as pandemic. The emergency that the world faces today demands that we develop urgent and effective measures to protect people at high risk of transmission. WHO has accelerated research in diagnostics, vaccines and therapeutics for this novel coronavirus.</p> Sumita Agrawal Akhil Dhanesh Goel Nitesh Gupta Copyright (c) 2020 The Author(s) 2020-03-30 2020-03-30 90 1 10.4081/monaldi.2020.1289 Factors contributing to drug-resistant tuberculosis treatment outcome in five countries in the Eastern Europe and Central Asia region <p>Drug-resistant tuberculosis (DR-TB) is a global challenge and a major contributor of death from anti-microbial resistance. With the main aim to determine factors contributing to treatment outcomes observed among DR-TB patients in the countries in Eastern Europe and Central Asia (EECA), a multi-method study was conducted in: Azerbaijan, Belarus, Romania, Tajikistan and Ukraine. Both quantitative and qualitative methodologies were used for data collection and analysis. The quantitative approaches included a desk review of documents related to the DR-TB responses and an analysis of clinical records of DR-TB patients in selected health facilities of the five countries. Qualitative methods included in-depth interviews with national TB programme (NTP) managers, other healthcare providers and non-governmental organizations (NGOs) workers, as well as interviews and Focus Group Discussions (FGDs) with DR-TB patients. The desk review of 38 reports identified as the main challenges to address DR-TB financial and/or management issues and adverse events of the medicines. The most common recommendations related to treatment outcome focussed on general programme management, treatment regimen composition, clinical management and social support for the patients. In all the five countries the NTPs still have a vertical structure. Some integration into the primary health care system (PHC) already exists but further involvement of PHC facilities is feasible and recommended. Interviews with stakeholders indicated that alcoholism and homelessness and a lack of appropriate response to these issues remain as major challenges for a sub-set of patients. Civil society groups, NGOs and communities are substantially engaged in providing different services to DR-TB patients, especially in Ukraine, Romania and Tajikistan. Data from clinical records of 212 patients revealed that independent risk factors for unfavourable treatment outcome (death, loss to follow-up, failure) were culture-positivity at two months of treatment, history of treatment with second-line drugs and homelessness. More powerful, less toxic and shorter oral treatment regimens as well as comprehensive patient support are needed to improve treatment outcome of patients with DR-TB.</p> Christian Auer Rais Mazitov Alisher Makhmudov Bobojon Pirmahmadzoda Alena Skrahina Andrei Dobre Florence Sécula Xavier Bosch-Capblanch Martin van den Boom Giovanni Battista Migliori Nino Mdivani Mohammed A. Yassin Copyright (c) 2020 The Author(s) 2020-03-30 2020-03-30 90 1 10.4081/monaldi.2020.1235