Advances in Diagnostics and Management of Respiratory System

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (31 October 2023) | Viewed by 10514

Special Issue Editors


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Guest Editor
SC Pneumologia, ASUGI, Trieste, Italy
Interests: pulmonary medicine; connective tissue diseases; rheumatic diseases; interstitial lung disease; nonspecific interstitial pneumonia; cell culture
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Guest Editor
Department of Pulmonology, University Hospital of Cattinara, Trieste, Italy
Interests: non-invasive ventilation (NIV); COVID-19 disease; lung cancer; acute respiratory distress syndrome (ARDS); idiopathic pulmonary fibrosis
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Guest Editor
Pulmonology Unit, Department of Medical Surgical and Health Sciences, University Hospital of Cattinara, University of Trieste, 34149 Trieste, Italy
Interests: COVID-19 disease; lung cancer; rheumatic diseases; idiopathic pulmonary fibrosis; interstitial lung diseases

Special Issue Information

Dear Colleagues, 

Over the last few decades, respiratory medicine has seen relevant progress in the development of innovative, less invasive, and even more accurate tools and technologies for the diagnosis and management of pulmonary diseases. First of all, more sophisticated and minimally invasive techniques were developed in interventional pulmonology, such as navigation platforms to diagnose and possibly treat peripheral pulmonary nodules, endobronchial ultrasound for the diagnosis of mediastinal and hilar adenopathy, cryobiopsy for the diagnosis of diffuse lung diseases, and medical pleuroscopy for the study of pleural diseases. Furthermore, bronchoscopy role in the management of patients with benign and malignant central airway obstruction was also increased, and interventional treatments for chronic diseases such as asthma and emphysema were developed.

In addition to interventional techniques, in recent years, significant advances in respiratory medicine have come from molecular medicine due to the genotyping of respiratory diseases, such as lung cancer, providing diagnostic targets for more specific and personal treatments.

Moreover, by taking advantage of digital technologies, the application of telemedicine is likely able to improve the management of chronic respiratory diseases, currently and in the future.

The main goal of this Special Issue is to summarize the most significant innovations in diagnostics and the management of respiratory system diseases, but also to stimulate new research in the field of respiratory diseases with a specific focus on developing innovative, scientific, and more personalized diagnostic and management tools that are aimed at increasing our knowledge in respiratory medicine and improving patient outcomes.

Dr. Paola Confalonieri
Dr. Barbara Ruaro
Dr. Francesco Salton
Dr. Riccardo Pozzan
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (7 papers)

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Editorial

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3 pages, 145 KiB  
Editorial
Advances in Diagnostics and Management of Respiratory System Diseases
by Paola Confalonieri, Francesco Salton, Marco Confalonieri, Riccardo Pozzan and Barbara Ruaro
Diagnostics 2024, 14(1), 20; https://doi.org/10.3390/diagnostics14010020 - 21 Dec 2023
Viewed by 756
Abstract
Recently, significant innovations in the diagnosis and management of respiratory diseases have been developed [...] Full article
(This article belongs to the Special Issue Advances in Diagnostics and Management of Respiratory System)

Research

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13 pages, 1861 KiB  
Article
Pulmonary Sarcoidosis and Immune Dysregulation: A Pilot Study on Possible Correlation
by Rossella Cifaldi, Francesco Salton, Paola Confalonieri, Liliana Trotta, Mariangela Barbieri, Luca Ruggero, Gianmaria Valeri, Riccardo Pozzan, Rossana Della Porta, Metka Kodric, Elisa Baratella, Mattia Bellan, Selene Lerda, Michael Hughes, Marco Confalonieri, Maria Assunta Cova, Ilaria Gandin, Lucrezia Mondini and Barbara Ruaro
Diagnostics 2023, 13(18), 2899; https://doi.org/10.3390/diagnostics13182899 - 11 Sep 2023
Cited by 2 | Viewed by 996
Abstract
Background: Sarcoidosis is a systemic inflammatory disease characterized by an altered inflammatory response. Objective: The aim of this study was to evaluate whether immune system alterations detected by lymphocyte typing in peripheral blood correlate with the severity of sarcoidosis, calculated according to two [...] Read more.
Background: Sarcoidosis is a systemic inflammatory disease characterized by an altered inflammatory response. Objective: The aim of this study was to evaluate whether immune system alterations detected by lymphocyte typing in peripheral blood correlate with the severity of sarcoidosis, calculated according to two separate severity scores proposed by Wasfi in 2006 and Hamzeh in 2010. Materials and Methods: Eighty-one patients were recruited, and clinical data and laboratory tests at the time of diagnosis were obtained in order to assess the severity index score and investigate any statistically significant correlation with the cytofluorimetry data. Results: Our data demonstrated that none of the two scores show an association with the level of total lymphocytes or lymphocyte subclasses. Limitations: First of all, the sample taken into consideration is small. The assessment was performed only at disease onset and not during the disease. Furthermore, the severity scores do not take into account disease activity (measured by PET/CT or gallium scintigraphy). Conclusions: Lymphocyte subpopulation values at the time of diagnosis do not appear to correlate with disease severity at onset. Full article
(This article belongs to the Special Issue Advances in Diagnostics and Management of Respiratory System)
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12 pages, 2495 KiB  
Article
Clinical and Prognostic Significance of p-ANCA Positivity in Idiopathic Pulmonary Fibrosis: A Retrospective Observational Study
by Alessandro Libra, Giuseppe Muscato, Giuseppe Ielo, Lucia Spicuzza, Stefano Palmucci, Evelina Fagone, Mary Fruciano, Elisa Gili, Gianluca Sambataro and Carlo Vancheri
Diagnostics 2023, 13(11), 1882; https://doi.org/10.3390/diagnostics13111882 - 27 May 2023
Cited by 3 | Viewed by 2501
Abstract
Perinuclear Anti Neutrophil Cytoplasmic Antibody (p-ANCA) is a serological marker of Microscopic Polyangiitis (MPA), a vasculitis associated with lung involvement potentially mimicking Idiopathic Pulmonary Fibrosis (IPF). In this study, we evaluated the role of p-ANCA in predicting clinical evolution and prognosis in a [...] Read more.
Perinuclear Anti Neutrophil Cytoplasmic Antibody (p-ANCA) is a serological marker of Microscopic Polyangiitis (MPA), a vasculitis associated with lung involvement potentially mimicking Idiopathic Pulmonary Fibrosis (IPF). In this study, we evaluated the role of p-ANCA in predicting clinical evolution and prognosis in a cohort of IPF patients. In this observational, retrospective, case–control study, we compared 18 patients with an IPF diagnosis and p-ANCA positivity with 36 patients with seronegative IPF, matched for age and sex. IPF patients with and without p-ANCA showed similar lung function decline during the follow-up, but IPF p-ANCA+ showed better survival. Half of IPF p-ANCA+ patients were classified as MPA for the development of renal involvement (55%) or skin signs (45%). The progression towards MPA was associated with high levels of Rheumatoid Factor (RF) at baseline. In conclusion, p-ANCA, mainly when associated with RF, could predict the evolution of Usual Interstitial Pneumonia (UIP) towards a definite vasculitis in patients, with a better prognosis compared with IPF. In this view, ANCA testing should be included in the diagnostic workup of UIP patients. Full article
(This article belongs to the Special Issue Advances in Diagnostics and Management of Respiratory System)
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Review

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18 pages, 372 KiB  
Review
High-Risk Sarcoidosis: A Focus on Pulmonary, Cardiac, Hepatic and Renal Advanced Diseases, as Well as on Calcium Metabolism Abnormalities
by Dominique Israël-Biet, Nicol Bernardinello, Jean Pastré, Claudio Tana and Paolo Spagnolo
Diagnostics 2024, 14(4), 395; https://doi.org/10.3390/diagnostics14040395 - 11 Feb 2024
Viewed by 1163
Abstract
Although sarcoidosis is generally regarded as a benign condition, approximately 20–30% of patients will develop a chronic and progressive disease. Advanced pulmonary fibrotic sarcoidosis and cardiac involvement are the main contributors to sarcoidosis morbidity and mortality, with failure of the liver and/or kidneys [...] Read more.
Although sarcoidosis is generally regarded as a benign condition, approximately 20–30% of patients will develop a chronic and progressive disease. Advanced pulmonary fibrotic sarcoidosis and cardiac involvement are the main contributors to sarcoidosis morbidity and mortality, with failure of the liver and/or kidneys representing additional life-threatening situations. In this review, we discuss diagnosis and treatment of each of these complications and highlight how the integration of clinical, pathological and radiological features may help predict the development of such high-risk situations in sarcoid patients. Full article
(This article belongs to the Special Issue Advances in Diagnostics and Management of Respiratory System)
17 pages, 319 KiB  
Review
The Evolving Concept of the Multidisciplinary Approach in the Diagnosis and Management of Interstitial Lung Diseases
by Stefano Sanduzzi Zamparelli, Alessandro Sanduzzi Zamparelli and Marialuisa Bocchino
Diagnostics 2023, 13(14), 2437; https://doi.org/10.3390/diagnostics13142437 - 21 Jul 2023
Cited by 5 | Viewed by 1769
Abstract
Background: Interstitial lung diseases (ILDs) are a group of heterogeneous diseases characterized by inflammation and/or fibrosis of the lung interstitium, leading to a wide range of clinical manifestations and outcomes. Over the years, the literature has demonstrated the increased diagnostic accuracy and confidence [...] Read more.
Background: Interstitial lung diseases (ILDs) are a group of heterogeneous diseases characterized by inflammation and/or fibrosis of the lung interstitium, leading to a wide range of clinical manifestations and outcomes. Over the years, the literature has demonstrated the increased diagnostic accuracy and confidence associated with a multidisciplinary approach (MDA) in assessing diseases involving lung parenchyma. This approach was recently emphasized by the latest guidelines from the American Thoracic Society, European Respiratory Society, Japanese Respiratory Society, and Latin American Thoracic Association for the diagnosis of ILDs. Methods: In this review, we will discuss the role, composition, and timing of multidisciplinary diagnosis (MDD) concerning idiopathic pulmonary fibrosis, connective tissue disease associated with ILDs, hypersensitive pneumonia, and idiopathic pneumonia with autoimmune features, based on the latest recommendations for their diagnosis. Results: The integration of clinical, radiological, histopathological, and, often, serological data is crucial in the early identification and management of ILDs, improving patient outcomes. Based on the recent endorsement of transbronchial cryo-biopsy in idiopathic pulmonary fibrosis guidelines, an MDA helps guide the choice of the sampling technique, obtaining the maximum diagnostic performance, and avoiding the execution of more invasive procedures such as a surgical lung biopsy. A multidisciplinary team should include pulmonologists, radiologists, pathologists, and, often, rheumatologists, being assembled regularly to achieve a consensus diagnosis and to review cases in light of new features. Conclusions: The literature highlighted that an MDA is essential to improve the accuracy and reliability of ILD diagnosis, allowing for the early optimization of therapy and reducing the need for invasive procedures. The multidisciplinary diagnosis of ILDs is an ongoing and dynamic process, often referred to as a “working diagnosis”, involving the progressive integration and re-evaluation of clinical, radiological, and histological features. Full article
(This article belongs to the Special Issue Advances in Diagnostics and Management of Respiratory System)

Other

6 pages, 5995 KiB  
Interesting Images
Sequence of Rare Diagnoses in a Young Patient: Altitude Barotrauma Hemopneumothorax and Desquamative Interstitial Pneumonia
by Iustina Leonte, Karina Ivanov, Angela Ștefania Marghescu, Șerban Radu Matache, Florica Valeria Negru, Ana Luiza Iorga, Silviu Mihail Dumitru and Beatrice Mahler
Diagnostics 2023, 13(14), 2367; https://doi.org/10.3390/diagnostics13142367 - 14 Jul 2023
Cited by 1 | Viewed by 905
Abstract
We present the case of a 35-year-old patient without pathological history who developed hemopneumothorax due to altitude barotrauma during a commercial airline flight. The computed tomography (CT) of the chest identified the presence of right hydropneumothorax and emphysema “blebs” and bubbles. After the [...] Read more.
We present the case of a 35-year-old patient without pathological history who developed hemopneumothorax due to altitude barotrauma during a commercial airline flight. The computed tomography (CT) of the chest identified the presence of right hydropneumothorax and emphysema “blebs” and bubbles. After the therapeutic insertion of a drain tube, the patient returned to the country by land transport. Three weeks later, he was diagnosed with right-sided pleurisy based on a CT scan with contrast material. A surgical intervention was then performed, and three biopsy samples were taken; the histopathological result highlighted suggestive elements for the diagnosis of desquamative interstitial pneumonia (DIP). Full article
(This article belongs to the Special Issue Advances in Diagnostics and Management of Respiratory System)
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12 pages, 1073 KiB  
Systematic Review
Pulmonary Ultrasonography in Systemic Sclerosis-Induced Interstitial Lung Disease—A Systematic Review and Meta-Analysis
by Mislav Radić, Hana Đogaš, Andrea Gelemanović, Slavica Jurić Petričević, Ivan Škopljanac and Josipa Radić
Diagnostics 2023, 13(8), 1429; https://doi.org/10.3390/diagnostics13081429 - 16 Apr 2023
Cited by 6 | Viewed by 1578
Abstract
Background: The aim of the current systematic review was to summarize and evaluate the overall advantages of lung ultrasonography (LUS) examination using high-resolution computed tomography (HRCT) as a reference standard in assessing the presence of interstitial lung disease (ILD) in systemic sclerosis (SSc) [...] Read more.
Background: The aim of the current systematic review was to summarize and evaluate the overall advantages of lung ultrasonography (LUS) examination using high-resolution computed tomography (HRCT) as a reference standard in assessing the presence of interstitial lung disease (ILD) in systemic sclerosis (SSc) patients. Methods: Databases PubMed, Scopus, and Web of Science were searched for studies evaluating LUSs in ILD assessments including SSc patients on 1 February 2023. In assessing risk of bias and applicability, the Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) was used. A meta-analysis was performed and the mean specificity, sensitivity, and diagnostic odds ratio (DOR) with a 95% confidence interval (CI) were obtained. In addition, in a bivariate meta-analysis, the summary receiver operating characteristic (SROC) curve area was additionally calculated. Results: Nine studies with a total of 888 participants entered the meta-analysis. A meta-analysis was also performed without one study that used pleural irregularity to assess the diagnostic accuracy of LUSs using B-lines (with a total of 868 participants). Overall sensitivity and specificity did not differ significantly, with only the analysis of the B-lines having a specificity of 0.61 (95% CI 0.44–0.85) and a sensitivity of 0.93 (95% CI 0.89–0.98). The diagnostic odds ratio of univariate analysis of the eight studies using the B-lines as a criterion for ILD diagnosis was 45.32 (95% CI 17.88–114.89). The AUC value of the SROC curve was 0.912 (and 0.917 in consideration of all nine studies), which indicates high sensitivity and a low false-positive rate for the majority of the included studies. Conclusions: LUS examination proved to be a valuable tool in discerning which SSc patients should receive additional HRCT scans to detect ILD and therefore reduces the doses of ionizing radiation exposure in SSc patients. However, further studies are needed to achieve consensus in scoring and the evaluation methodology of LUS examination. Full article
(This article belongs to the Special Issue Advances in Diagnostics and Management of Respiratory System)
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