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  • 1
    Online Resource
    Online Resource
    Awake prone positioning in non-intubated patients for the management of hypoxemia in COVID-19: A systematic review and meta-analysis
    PAGEPress Publications ; 2021
    In:  Monaldi Archives for Chest Disease Vol. 91, No. 2 ( 2021-04-22)
    Details
    In: Monaldi Archives for Chest Disease, PAGEPress Publications, Vol. 91, No. 2 ( 2021-04-22)
    Abstract: Coronavirus disease-2019 (COVID-19) may lead to hypoxemia, requiring intensive care in many patients. Awake prone positioning (PP) is reported to improve oxygenation and is a relatively safe modality. We performed a systematic review of the literature to evaluate the available evidence and performed meta-analysis of the effect of awake PP in non-intubated patients on improvement in oxygenation and reducing the need for intubation. We searched the PubMed and EMBASE databases to identify studies using awake PP as a therapeutic strategy in the management of COVID-19. Studies were included if they reported respiratory outcomes and included five or more subjects. The quality of individual studies was assessed by the Qualsyst tool. A meta-analysis was performed to estimate the proportion of patients requiring intubation. The degree of improvement in oxygenation parameters (PaO2: FiO2 or PaO2 or SpO2) was also calculated. Sixteen studies (seven prospective trials, three before-after studies, six retrospective series) were selected for review. The pooled proportion of patients who required mechanical ventilation was 0.25 (95% confidence interval (CI) 0.16-0.34). There was a significant improvement in PaO2: FiO2 ratio, PaO2, and SpO2 during awake PP. To conclude, there is limited evidence to support the efficacy of awake PP for the management of hypoxemia in COVID-19. Further RCTs are required to study the impact of awake PP on key parameters like avoidance of mechanical ventilation, length of stay, and mortality.
    Type of Medium: Online Resource
    ISSN: 2532-5264 , 1122-0643
    URL: Article
    DOI: 10.4081/monaldi.2021.1623
    Language: Unknown
    Publisher: PAGEPress Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2375904-5
    detail.hit.zdb_id: 2375907-0
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  • 2
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    Online Resource
    Association of air pollution and coronavirus disease 2019 (COVID-19) in India
    PAGEPress Publications ; 2023
    In:  Monaldi Archives for Chest Disease ( 2023-06-15)
    Details
    In: Monaldi Archives for Chest Disease, PAGEPress Publications, ( 2023-06-15)
    Abstract: The COVID-19 pandemic has affected the world, leading to significant morbidity and mortality. Various meteorological parameters are considered essential for the viability and transmission of the virus. Multiple reports from various parts of the world suggest a correlation between the disease spread and air pollution severity. This study was carried out to identify the relationship between meteorological parameters, air pollution, and COVID-19 in New Delhi, one of the worst-affected states in India. We studied air pollution and meteorological parameters in New Delhi, India. We obtained data about COVID-19 occurrence, meteorological parameters, and air pollution indicators from various sources from Apr 1, 2020, till Nov 12, 2020. We performed correlational analysis and employed autoregressive distributed lag models (ARDLM) for identifying the relationship between COVID-19 cases with air pollution and meteorological parameters. We found a significant impact of PM 2.5, PM 10, and meteorological parameters on COVID-19. There was a significant positive correlation between daily COVID-19 cases and COVID-19-related deaths with PM2.5 and PM10 levels. Increasing temperature and windspeed were associated with a reduction in the number of cases while increasing humidity was associated with increased cases. This study demonstrated a significant association of PM2.5 and PM10 with daily COVID-19 cases and COVID-19-related mortality. This knowledge will likely help us prepare well for the future and implement air pollution control measures for other airborne disease epidemics.
    Type of Medium: Online Resource
    ISSN: 2532-5264 , 1122-0643
    URL: Article
    DOI: 10.4081/monaldi.2023.2537
    Language: Unknown
    Publisher: PAGEPress Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2375904-5
    detail.hit.zdb_id: 2375907-0
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  • 3
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    Online Resource
    Light sedation or no-sedation in ICU: patient experience matters
    PAGEPress Publications ; 2020
    In:  Monaldi Archives for Chest Disease Vol. 90, No. 3 ( 2020-07-29)
    Details
    In: Monaldi Archives for Chest Disease, PAGEPress Publications, Vol. 90, No. 3 ( 2020-07-29)
    Abstract: Dear Editor, We have been using sedation for a long time in intensive care units for patients on mechanical ventilation. Sedation aims at facilitating the patient’s ability to remain comfortably connected to the ventilator and minimize oxygen consumption. The strategies for sedation vary from deep sedation and light sedation to nosedation. For the last two decades, light sedation with daily interruption is being practiced by most ICUs...
    Type of Medium: Online Resource
    ISSN: 2532-5264 , 1122-0643
    URL: Article
    DOI: 10.4081/monaldi.2020.1401
    Language: Unknown
    Publisher: PAGEPress Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2375904-5
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  • 4
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    Assessment of the impact and reorganization of interventional pulmonology services at a tertiary care centre during nationwide lockdown for COVID-19 pandemic
    PAGEPress Publications ; 2021
    In:  Monaldi Archives for Chest Disease Vol. 91, No. 1 ( 2021-01-25)
    Details
    In: Monaldi Archives for Chest Disease, PAGEPress Publications, Vol. 91, No. 1 ( 2021-01-25)
    Abstract: COVID 19 pandemic has brought about a sea change in health care practices across the globe. All specialities have changed their way of working during the pandemic. In this study, we evaluated the impact of COVID-19 on the practice of interventional pulmonology at our centre. All interventional pulmonology procedures done during the three months after implementation of lockdown were evaluated retrospectively for patient demographics, clinical diagnosis, indication for procedure and diagnostic accuracy. The changes in practices, additional human resources requirement, the additional cost per procedure and impact on resident training were also assessed. Procedures done during the month of January 2020 were used as controls for comparison. Twenty-two flexible bronchoscopies (75.8%), four semirigid thoracoscopies (13.7%) and three EBUS-TBNAs (10.3%) were carried out during three month lockdown period as compared to 174 during January 2020. Twenty-three of the procedures were for the diagnostic indication (79%), and six were therapeutic (20.6%). The diagnostic yield in suspected neoplasm was 100% while for suspected infections was 58.3%. The percentage of independent procedures being done by residents reduced from 45.4% to 0%. The workforce required per procedure increased from 0.75 to 4-8, and the additional cost per procedure came out to be 135 USD. To conclude, COVID 19 has impacted the interventional pulmonology services in various ways and brought about a need to reorganize the services, while also thinking of innovative ideas to reduce cost without compromising patient safety.
    Type of Medium: Online Resource
    ISSN: 2532-5264 , 1122-0643
    URL: Article
    DOI: 10.4081/monaldi.2021.1615
    Language: Unknown
    Publisher: PAGEPress Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2375904-5
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  • 5
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    Online Resource
    Secretion management in patients with ineffective airway clearance with non-invasive mechanical ventilation use: Expert guidance for clinical practice
    PAGEPress Publications ; 2021
    In:  Monaldi Archives for Chest Disease ( 2021-06-07)
    Details
    In: Monaldi Archives for Chest Disease, PAGEPress Publications, ( 2021-06-07)
    Abstract: Non-invasive ventilation (NIV) is a mainstay of management of chronic respiratory failure in many disorders which are known to cause abnormal airway secretion clearance. Currently, there is no guidance regarding either the secretion handling during NIV use or the role of NIV in secretion management in these patients. The aim of this document was to provide an overview of the various techniques available in the management of respiratory secretions and their use in conjunction with NIV. Literature search was performed using the keywords, “(secretion OR secretions) AND (noninvasive ventilation OR NIV)” on PubMed and EMBASE. The search yielded 1681 and 509 titles from PubMed and EMBASE, respectively. After screening, 19 articles were included in this review. Suggestions of the expert panel were formulated by mutual consensus after reviewing the relevant literature. The draft of the expert panel’s suggestions was circulated among all authors via electronic mail for comments. Any conflicts were resolved by mutual discussion to achieve agreement. The final document was approved by all. This document by the International Network for Airway Secretions Management in NIV describes various airway secretion clearance techniques. It provides the expert panel’s suggestions for the use of these techniques in conjunction with NIV for patients with muco-obstructive and neuromuscular disorders. 
    Type of Medium: Online Resource
    ISSN: 2532-5264 , 1122-0643
    URL: Article
    DOI: 10.4081/monaldi.2021.1499
    Language: Unknown
    Publisher: PAGEPress Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2375904-5
    detail.hit.zdb_id: 2375907-0
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  • 6
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    Online Resource
    Steroid therapy for COVID-19: A systematic review and meta-analysis of randomized controlled trials
    PAGEPress Publications ; 2021
    In:  Monaldi Archives for Chest Disease ( 2021-07-21)
    Details
    In: Monaldi Archives for Chest Disease, PAGEPress Publications, ( 2021-07-21)
    Abstract: There is an urgent need for effective treatment modalities for coronavirus disease 2019 (COVID-19). Data for the use of steroids in COVID-19 is emerging. We conducted this systematic review and meta-analysis to estimate the effectiveness of steroid administration in mortality reduction due to COVID-19 compared to the control group. A systematic search of the Pubmed and Embase databases was performed to extract randomized controlled trials (RCTs) regarding the use of steroid therapy for COVID-19. An overall and subgroup (based upon the type of steroid) pooled mortality analysis was performed, and odds ratios were reported. Cochrane risk of bias assessment tool was used to assess the risk of bias. Heterogeneity was assessed using the I2 statistic. Six RCTs, including 7707 patients, were selected for review. Three trials reported 28-day mortality, and two trials reported 21-day mortality, and one trial reported in-hospital mortality. There were 730 deaths among 2837 participants in the steroid group while 1342 deaths among 4870 patients randomized to the control group (Odds ratio 0.76, 95% confidence interval 0.58-1.00, p=0.05). The effect was significant in patients on oxygen or mechanical ventilation. There was no difference in the various preparations and doses of the steroids. There was heterogeneity among the trials as the I2 value was 53%, with a p-value of 0.06. There was no indication of increased serious adverse events. This meta-analysis of RCTs demonstrated that the use of systemic corticosteroids is associated with a reduction in all-cause mortality in patients with COVID-19 on oxygen or mechanical ventilation.
    Type of Medium: Online Resource
    ISSN: 2532-5264 , 1122-0643
    URL: Article
    DOI: 10.4081/monaldi.2021.1716
    Language: Unknown
    Publisher: PAGEPress Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2375904-5
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  • 7
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    Online Resource
    Tocilizumab for COVID-19: A systematic review and meta-analysis of randomized controlled trials
    PAGEPress Publications ; 2022
    In:  Monaldi Archives for Chest Disease ( 2022-02-04)
    Details
    In: Monaldi Archives for Chest Disease, PAGEPress Publications, ( 2022-02-04)
    Abstract: The effective treatment modalities for severe coronavirus disease 2019 (COVID-19) are needed. As the primary cause of mortality is a hyperinflammatory state, the interleukin-6 antagonist tocilizumab has been used in multiple clinical studies. We conducted this systematic review and meta-analysis to estimate the effectiveness of tocilizumab in reduction of mortality due to COVID-19. A systematic search of the Pubmed and Embase databases was performed to extract randomized controlled trials (RCTs) regarding the use of tocilizumab therapy for COVID-19. An overall pooled mortality analysis was performed, and odds ratios were reported. Cochrane risk of bias assessment tool was used to assess the risk of bias. Heterogeneity was assessed using the I2 statistic. Nine RCTs, including 6489 patients, were selected for meta-analysis. Seven trials reported 28-day mortality, and one trial each reported 21-day and 30-day mortality. There were 846 deaths among 3358 participants in the steroid group while 943 deaths among 3131 patients randomized to the control group (random-effects odds ratio 0.87, 95% confidence interval 0.73-1.03, p=0.11). There was some heterogeneity among the trials as the I2 value was 15%, with a p-value of 0.31. There was a reduction in the need for ICU admission in the tocilizumab group. A higher risk of secondary infections was noted in the tocilizumab group (fixed-effects odds ratio 0.72, 95% confidence interval 0.55-0.95, p=0.02). This meta-analysis of RCTs demonstrated that the use of tocilizumab was not associated with a reduction in all-cause mortality in patients with COVID-19 and had higher odds of secondary infections.  
    Type of Medium: Online Resource
    ISSN: 2532-5264 , 1122-0643
    URL: Article
    DOI: 10.4081/monaldi.2022.2136
    Language: Unknown
    Publisher: PAGEPress Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2375904-5
    detail.hit.zdb_id: 2375907-0
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  • 8
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    Online Resource
    Utilization of endobronchial electrocautery for removal of an impacted airway foreign body
    PAGEPress Publications ; 2020
    In:  Monaldi Archives for Chest Disease Vol. 90, No. 3 ( 2020-07-31)
    Details
    In: Monaldi Archives for Chest Disease, PAGEPress Publications, Vol. 90, No. 3 ( 2020-07-31)
    Abstract: Dear Editor, Aspiration of a foreign body into the tracheobronchial tree can occur at any age, though it occurs more commonly in children. In small children, the foreign body commonly gets lodged in the central airways (trachea and mainstem bronchi); hence, the presentation is usually sudden onset of cough and dyspnea or even lifethreatening respiratory failure in an otherwise healthy child. A witnessed aspiration or a history of aspiration can usually be elicited.
    Type of Medium: Online Resource
    ISSN: 2532-5264 , 1122-0643
    URL: Article
    DOI: 10.4081/monaldi.2020.1383
    Language: Unknown
    Publisher: PAGEPress Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2375904-5
    detail.hit.zdb_id: 2375907-0
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  • 9
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    Online Resource
    Tuberculosis endemicity and BCG vaccination: Protection against COVID-19
    PAGEPress Publications ; 2022
    In:  Monaldi Archives for Chest Disease ( 2022-06-24)
    Details
    In: Monaldi Archives for Chest Disease, PAGEPress Publications, ( 2022-06-24)
    Abstract: The coronavirus disease 2019 (COVID-19) has affected different countries in a differential manner. The host susceptibility and host factors are important parameters for this variability. This study aimed to assess the effect of tuberculosis (TB) endemicity and Bacille Calmette-Guerin (BCG) coverage on COVID-19. Available data regarding TB incidence, BCG coverage (as per the World Health Organization), and COVID-19 incidence of 168 countries as of 19th September 2021. Countries were divided into four cohorts based upon annual TB incidence and BCG coverage and COVID-19 incidence and case fatality rates were compared using the Kruskal-Wallis test. Countries with low TB incidence and low BCG coverage had the highest COVID-19 incidence per lac population. However, no significant difference was seen in COVID-19 cases fatality rate. Higher TB incidence and BCG coverage were associated with lesser incidence of COVID-19. This result paves the way for research into pathogenesis and host immune response in COVID-19.
    Type of Medium: Online Resource
    ISSN: 2532-5264 , 1122-0643
    URL: Article
    DOI: 10.4081/monaldi.2022.2281
    Language: Unknown
    Publisher: PAGEPress Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2375904-5
    detail.hit.zdb_id: 2375907-0
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