1. Wendelboe AM, Raskob GE. Global Burden of Thrombosis: Epidemiologic Aspects. Circ Res. 2016;118(9):1340-1347. doi:10.1161/CIRCRESAHA.115.306841 CrossRef Google Scholar

INTRODUCTION Chronic cough (CC) presents a widespread and intricate challenge for diagnosis and treatment, revealing a significant lack of information on medical strategies. This study aims to gather insights from different practitioners in Southern Italy regarding their views and methodologies towards CC. METHODS The investigation engaged 102 medical practitioners from Southern Italy, encompassing 23 general practitioners, 30 pulmonologists, 25 allergologists, and 24 otolaryngologists. It examined their understanding, attitudes, and approaches towards managing CC, with an emphasis on diagnostic processes, treatment preferences, and adherence to guidelines. RESULTS The findings highlight distinct variations in the management of chronic cough among different medical specialists. Notably, otolaryngologists and pulmonologists tend to categorize chronic cough as lasting for more extended periods than allergists and general practitioners. Pulmonologists, in particular, are more prone to suggest chest X-rays for chronic cough patients, reflecting their focus on lung-related conditions. In terms of the primary causes of CC, allergists and pulmonologists often attribute it to asthma, general practitioners to gastro-esophageal reflux disease, and otolaryngologists to upper airways cough syndrome. Pulmonologists are also observed to have the most comprehensive awareness of the various conditions associated with coughing, which is likely due to their specialization in respiratory health. CONCLUSIONS The research underscores the necessity for enhanced education and standardized procedures among healthcare providers in Southern Italy for managing CC, highlighting the importance of interdisciplinary cooperation and customized treatment plans to improve the outcomes for patients with CC and guide future therapeutic strategies.

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Both H1N1 and SARS-CoV-2, two primarily respiratory viruses, resulted in many cases of patients with Acute Respiratory Distress Syndrome (ARDS). ARDS according to the Berlin Criteria (2012), is defined as respiratory distress of acute onset (within a week of a clinical incident), with diffuse lung infiltrates on chest X-ray, without underlying cardiac failure or abnormally positive fluid balance. The activation and dysregulation of multiple pathways of injury and inflammation, including coagulation, are the main constituents of ARDS pathophysiology 3 . Also, partial pressure of oxygen in the arterial blood to the fraction of inspired oxygen concentration PaO 2 /FiO 2 should be ≤300 4 . Causes of ARDS are divided into pulmonary, which could be respiratory tract infection or lung injury, and extrapulmonary, like burns, prior non-thoracic operation, extrapulmonary infection etc. In terms of hospital mortality, it is 34.9% for mild disease, 40.3% for moderate, and 50.4% for severe ARDS5. Finally, ARDS is the primary cause of Intensive Care Unit (ICU) admissions. According to the World Health Organization (WHO), risk factors for worse prognosis for H1N1 virus disease are young

COVID-19 is an infectious disease declared as pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as was designated by the World Health Organization in February 2020 1 .The first cluster of cases was reported in the city of Wuhan, in China on the 31 December 2019 as 'pneumonia of unknown cause', later identifying the novel virus responsible for the disease.COVID-19 is a multisystem inflammatory syndrome with a rather wide variety of symptoms, the most common of which are fever, cough, fatigue, myalgia, headache, nasal obstruction/rhinorrhea, sore throat and loss of smell 2 , along with up to 32% of asymptomatic cases 3 .According to WHO, the disease severity classification includes 3 categories of patients, those with non-severe, severe, and critical disease.The last regards patients with acute respiratory distress syndrome (ARDS) and other life-threatening situations 4 .ARDS is an acute, diffuse, inflammatory lung injury with acute hypoxemia, decreasing lung compliance and bilateral opacities.The damage to the alveolar-capillary membrane leads to increased permeability and subsequent interstitial and alveolar oedema, resulting in severe hypoxemia due to intrapulmonary shunting and V/Q mismatch 5 .Primary goal in treating ARDS is to improve patient ventilation.The improvement of ventilation during prone position is multifactorial; while in supine position, ventral transpulmonary pressure is greater than dorsal, resulting in overinflation of ventral alveoli and atelectasis of dorsal ones.On the other hand, prone position reduces ventral and dorsal transpulmonary pressure, making ventilation more homogeneous 6 .The application of positive end-expiratory pressure (PEEP) leads to more uniform pressure distribution, lung expansion and alveolar recruitment.In patients with ARDS in supine position, the heart and diaphragm compress the posterior lung parenchyma.Lung compression by both the heart and the diaphragm can be favorably affected by prone positioning, allowing previously non-ventilated lung regions to participate in the gas exchange 7 .At the same time, pulmonary perfusion remains distributed mainly to the dorsal lung regions.In other words, the gravitational distribution of pulmonary blood flow may be only minimally altered by prone position and the observed changes in gas exchange are primary due to changes in regional ventilation, thus improving overall alveolar ventilation/ perfusion relationships 8 .Moreover, the reduction of hypoxic vasoconstriction in prone position decreases right heart afterload, resulting in a decrease in pulmonary resistance.Additionally, secretion drainage seems to be improved due to gravitational effect.Prone positioning combined with mechanical ventilation has shown significant improvement in oxygenation and ventilation 9 .In order to avoid the progression of COVID-19 pneumonia ABSTRACT INTRODUCTION COVID-19 is an inflammatory disease with variable symptoms.Critical cases with ARDS on invasive mechanical ventilation benefit from prone positioning.The aim of the review is to determine the effect of prone position in spontaneously breathing patients with COVID-19.METHODS The PubMed database was used for article research using the following search string: (prone position) AND (COVID-19).After the evaluation of eligibility of the initial number of articles, 31 studies were used for the current review.RESULTS The population of the patients, methods of oxygenation, inclusion and exclusion criteria for participating in each study, outcomes and results of the studies are examined and presented.CONCLUSIONS The majority of evidence showed beneficial effect of prone positioning in hypoxemia in non-intubated spontaneously breathing patients with COVID-19, although the heterogeneity of study designs limits the safe conduct of conclusions, indicating the need for large scale randomized control studies to ensure the credibility of the results.

1. Parri N, Lenge M, Buonsenso D; Coronavirus Infection in Pediatric Emergency Departments (CONFIDENCE) Research Group. Children with Covid-19 in Pediatric Emergency Departments in Italy. N Engl J Med. 2020;383(2):187-190. doi:10.1056/NEJMc2007617 CrossRef Google Scholar

INTRODUCTION There is a current lack of epidemiological data regarding lung cancer in Greece.The aim of this study was to record and analyze pertinent data regarding demographic, clinical, radiological, bronchoscopic and histological findings in lung cancer cases over a ten-year period collected from a hospital in Central Greece, and to investigate potential specific features of lung cancer in Greek patients.METHODS This was a retrospective cohort study.The data collected were obtained from newly diagnosed lung cancer patients with fiberoptic bronchoscopy during a ten-year period (2009-2018).From the database, we have extracted the demographic data, the tumor location based on the computed tomography (CT) scans, bronchoscopy report with associated images and the histopathology/cytology reports that yielded the diagnosis.RESULTS A total number of 637 patients were diagnosed with primary lung cancer during the decade 2009-2018 from the authors in a major tertiary hospital in Athens, Greece.Most of the patients were aged 50-69 years (57.6%) and the majority were men (77.1%) and active smokers (74.1%).The most common histological type was adenocarcinoma (31.7%).In the majority of cases, the patients presented initially at advanced stages.At the time of diagnosis, the most common finding was a lung mass or nodule in computed tomography and an endobronchial mass in fiberoptic bronchoscopy.The patients' lesions were detected most frequently in the upper lobes.CONCLUSIONS The results show a trend in ADLC histology, an increase in the proportion of women with lung cancer and highlight the significant percentage of patients diagnosed in advanced stages.This reflects the need for effective tobacco control strategies to reduce the incidence of lung cancer and a comprehensive national screening program for the purposes of early detection.

1. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease 2018 Report. Global Initiative for Chronic Obstructive Lung Disease; 2018. Accessed May 4, 2023. https://goldcopd.org/wp-conten... Google Scholar