Pulmonary Disease: Diagnosis and Management

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 August 2024) | Viewed by 3501

Special Issue Editor


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Guest Editor
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
Interests: pulmonary; tuberculosis; diagnosis; resistance; treatment; nontuberculous mycobacteria
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Special Issue Information

Dear Colleagues,

Pulmonary diseases have exerted a considerable impact on human health throughout history. A myriad of viruses and bacterial pathogens induce pulmonary infections. In the past few years, the etiological agents of severe infectious diseases, including COVID-19, have been identified. Concurrently, persistent challenges such as tuberculosis and the global surge in nontuberculous mycobacteria pulmonary disease demand ongoing attention. Furthermore, conditions associated with high mortality rates, such as lung cancer and interstitial lung diseases, present complex pathophysiological mechanisms that necessitate further investigation. Chronic airway diseases, notably chronic obstructive pulmonary disease and bronchiectasis, continue to escalate the healthcare burden.

Recent progress in diverse research methodologies has substantially enhanced the diagnostic and therapeutic landscape of respiratory conditions. Applications of molecular diagnostics, single-cell RNA sequencing, microbiome analyses, and organoid models to pulmonary disease research are proliferating. These approaches have yielded numerous instruments for elucidating etiology, refining diagnostic criteria, forecasting prognoses, and identifying therapeutic targets. In the context of emerging pharmacotherapies, active scholarly collaboration and the swift, precise dissemination of research findings among scientists are paramount.

Accordingly, this special issue is dedicated to presenting an updated compendium of advancements in pulmonary medicine, aiming to stimulate interest and discourse in the domain.

Dr. Byung Woo Jhun
Guest Editor

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Keywords

  • pulmonary disease
  • lung disease
  • chronic airway diseases
  • diagnosis
  • treatment
  • prognosis

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Published Papers (3 papers)

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Research

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29 pages, 7196 KiB  
Article
Feature Identification Using Interpretability Machine Learning Predicting Risk Factors for Disease Severity of In-Patients with COVID-19 in South Florida
by Debarshi Datta, Subhosit Ray, Laurie Martinez, David Newman, Safiya George Dalmida, Javad Hashemi, Candice Sareli and Paula Eckardt
Diagnostics 2024, 14(17), 1866; https://doi.org/10.3390/diagnostics14171866 - 26 Aug 2024
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Abstract
Objective: The objective of the study was to establish an AI-driven decision support system by identifying the most important features in the severity of disease for Intensive Care Unit (ICU) with Mechanical Ventilation (MV) requirement, ICU, and I [...] Read more.
Objective: The objective of the study was to establish an AI-driven decision support system by identifying the most important features in the severity of disease for Intensive Care Unit (ICU) with Mechanical Ventilation (MV) requirement, ICU, and InterMediate Care Unit (IMCU) admission for hospitalized patients with COVID-19 in South Florida. The features implicated in the risk factors identified by the model interpretability can be used to forecast treatment plans faster before critical conditions exacerbate. Methods: We analyzed eHR data from 5371 patients diagnosed with COVID-19 from South Florida Memorial Healthcare Systems admitted between March 2020 and January 2021 to predict the need for ICU with MV, ICU, and IMCU admission. A Random Forest classifier was trained on patients’ data augmented by SMOTE, collected at hospital admission. We then compared the importance of features utilizing different model interpretability analyses, such as SHAP, MDI, and Permutation Importance. Results: The models for ICU with MV, ICU, and IMCU admission identified the following factors overlapping as the most important predictors among the three outcomes: age, race, sex, BMI, diarrhea, diabetes, hypertension, early stages of kidney disease, and pneumonia. It was observed that individuals over 65 years (‘older adults’), males, current smokers, and BMI classified as ‘overweight’ and ‘obese’ were at greater risk of severity of illness. The severity was intensified by the co-occurrence of two interacting features (e.g., diarrhea and diabetes). Conclusions: The top features identified by the models’ interpretability were from the ‘sociodemographic characteristics’, ‘pre-hospital comorbidities’, and ‘medications’ categories. However, ‘pre-hospital comorbidities’ played a vital role in different critical conditions. In addition to individual feature importance, the feature interactions also provide crucial information for predicting the most likely outcome of patients’ conditions when urgent treatment plans are needed during the surge of patients during the pandemic. Full article
(This article belongs to the Special Issue Pulmonary Disease: Diagnosis and Management)
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13 pages, 3364 KiB  
Article
Time-Sequential Monitoring of the Early Mesothelial Reaction in the Pleura after Cryoinjury
by Taeyun Kim, Yu-Kyung Chae, Sung-Jin Nam, Haeyoung Lee, Sang-Suk Hwang, Eun-Kee Park, Yeh-Chan Ahn and Chulho Oak
Diagnostics 2024, 14(3), 292; https://doi.org/10.3390/diagnostics14030292 - 29 Jan 2024
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Abstract
(1) Background: An early mesothelial reaction of the pleura, leading to fibrosis, has been reported in animals after chemical or heavy metal exposure. However, the visual monitoring of early time-sequential mesothelial reaction-associated cryoinjury has not been fully investigated. Therefore, this study aimed to [...] Read more.
(1) Background: An early mesothelial reaction of the pleura, leading to fibrosis, has been reported in animals after chemical or heavy metal exposure. However, the visual monitoring of early time-sequential mesothelial reaction-associated cryoinjury has not been fully investigated. Therefore, this study aimed to evaluate and visualize the early mesothelial reactions seen following cryoinjury using rabbit pleura. (2) Methods: We monitored the early mesothelial reaction in rabbit pleurae after cryoinjury using optical coherence tomography (OCT), in real-time, which was then compared with pathological images. Due to the penetration limit of OCT, we made a thoracic window to image the parietal and visceral pleurae in vivo. We also used an innovative technique for capturing the microstructure in vivo, employing a computer-controlled intermittent iso-pressure breath hold to reduce respiratory motion, increasing the resolution of OCT. We organized three sample groups: the normal group, the sham group with just a thoracic window, and the experimental group with a thoracic window and cryotherapy. In the experimental group, localized cryoinjury was performed. The mesothelial cells at the level of pleura of the cryotherapy-injured site were visualized by OCT within the first 30 min and then again after 2 days at the same site. (3) Results: In the experimental group, focal thickening of the parietal pleura was observed at the site of cryoinjury using OCT after the first injury, and it was then confirmed pathologically as focal mesothelial cell proliferation. Two days after cryoinjury, diffuse mesothelial cell proliferation in the parietal pleura was noted on the reverse side around the cryoinjured site in the same rabbit. In the sham group, no pleural reaction was found. The OCT and pathological examinations revealed different patterns of mesothelial cell reactions between the parietal and visceral pleurae: the focal proliferation of mesothelial cells was found in the parietal pleura, while only a morphological change from flat cells to cuboidal cells and a thickened monolayer without proliferation of mesothelial cells were found in the visceral pleural. (4) Conclusions: An early mesothelial reaction occurs following cryoinjury to the parietal and visceral pleurae. Full article
(This article belongs to the Special Issue Pulmonary Disease: Diagnosis and Management)
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Review

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12 pages, 223 KiB  
Review
A Review of Current Evidence for the Use of Steroids in the Medical Intensive Care Unit
by Patrick Jenkins, Cory Cross, Tony Abdo, Houssein Youness and Jean Keddissi
Diagnostics 2024, 14(14), 1565; https://doi.org/10.3390/diagnostics14141565 - 19 Jul 2024
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Abstract
Systemic steroids are frequently used in critically ill patients for their anti-inflammatory properties. Potential benefits of these agents should be balanced against their known side effects. In this paper, we review trials assessing the use of systemic steroids in common conditions requiring admission [...] Read more.
Systemic steroids are frequently used in critically ill patients for their anti-inflammatory properties. Potential benefits of these agents should be balanced against their known side effects. In this paper, we review trials assessing the use of systemic steroids in common conditions requiring admission to the intensive care unit. These include septic shock, the acute respiratory distress syndrome, severe pneumonia, COVID-19, and hypercapnic respiratory failure due to chronic obstructive pulmonary disease. We will mainly focus on well-conducted randomized controlled trials to determine whether steroids should be administered to critically ill patients presenting with these conditions. Full article
(This article belongs to the Special Issue Pulmonary Disease: Diagnosis and Management)
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