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> en-US <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> (Nadia Moscato) (Tiziano Taccini) Tue, 21 Jan 2020 14:14:18 +0000 OJS 60 Three dimensional echocardiographic imaging of multiple recurrent myxomas <p>We report a case of a recurrence of 5 cardiac myxomas in both atria with atypical anatomical features difficult to image. Although a multimodality imaging was performed, three-dimensional echocardiography (3DE) was the only technique able to correctly identify all the recurrences and the anatomical characteristics of the myxomas. MRI detected the blood supply of the mass but even after careful review was able to identify only 4 of the 5 lesions. Even though it was already reported the usefulness of 3DE to better delineate the site of attachment of cardiac tumors, it was never reported its sensibility in the setting of multiple myxomas; this case highlights the ability of the 3DE in this challenging scenario and its potential for being considered the key adjunctive modality for the anatomy when advanced surgical plan is required.</p> Reem Al Sergani, Bander Alamro, Mohammed Al Admawi, Isra Elmahi, Gabriella Iannuzzo, Antonio Cittadini, Domenico Galzerano, Khaled M. AlKattan ##submission.copyrightStatement## Tue, 21 Jan 2020 14:13:31 +0000 High flow nasal cannula in acute hypercapnic exacerbation of chronic obstructive pulmonary disease: an emerging utility <p class="Pa11" style="text-align: justify; line-height: normal;"><span lang="EN-US" style="font-family: 'Times New Roman',serif;">High flow <span style="color: black;">nasal cannula (HFNC) provides warmed and humidified air with flow rates up to 60 liters/min with relatively fixed oxygen content (FiO<sub>2</sub>). It has been extensively evaluated for hypoxemic respiratory failure and has been used in mild acute respiratory distress syndrome, pre-intubation, bronchoscopy and pediatric obstructive sleep apnea. Recent data has suggested a role in stable hypercapnic chronic obstructive pulmonary disease (COPD) and even in acute exacerbations, though, the use has not been advocated by any guidelines yet. We present a case of acute hypercapnic exacerbation of COPD, intolerant to non-invasive ventilation, showing response and improvement on use of HFNC. This case highlights this potential mechanisms and prospects for the same.</span></span></p> Anshul Mittal, Megha Varshney, Vidushi Rathi, Pranav Ish ##submission.copyrightStatement## Tue, 21 Jan 2020 14:05:46 +0000 Common swelling of the dorsal thoracic wall brings an unexpected finding: elastofibroma dorsi <p>Elastofibroma is a rare benign, soft-tissue slow-growing tumor seen predominantly in elderly females. We present such a case in a 46-year-old female. She presented with gradually increasing soft tissue swelling of 8×6 cm in the right inferior subscapular region. MRI showed a large intramuscular lesion with atypia. She underwent excisional biopsy and the histopathology and immunochemistry showed elastofibroma. We present this rare case to emphasize the important role of the diagnostic tools. A definitive diagnosis helps to avoid unnecessary wide and radical resection.</p> Sotirios Kotoulas, Konstantinos Grapatsas, Charalampos Georgiou, Zoi Tsilogianni, Vasileios Leivaditis, Mariana Braga Lopes Rufino, Christophoros Kotoulas ##submission.copyrightStatement## Tue, 21 Jan 2020 14:01:39 +0000 Three’s company: A woman with rash, uterine mass and cystic lungs <p>Cystic lung disease encompasses a wide variety of clinical entities, the diagnosis of which is sometimes straightforward and other times obscure.&nbsp; To narrow the list of possibilities, it behooves the physician to consider the context in which the cystic lung disease is uncovered. Clues to the diagnosis might be provided by findings that are not initially obvious and are not located in the thorax. We describe an instructive case of a woman with cystic lungs detected during a search for malignancy prompted by a diagnosis of dermatomyositis. Malignancy was indeed uncovered in the form of endometrial carcinoma, the management of which eventually also established the etiology of cystic lung disease. In the discussion we attempt to connect the patient’s autoimmune disease, uterine cancer, and lung cysts. The potential interplay among these three components of her presentation makes for intriguing mechanistic speculation.</p> Laura Miranda, Sarwat Gilani, Liying Han, Oleg Epelbaum ##submission.copyrightStatement## Tue, 21 Jan 2020 13:55:21 +0000