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A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Critical Care".

Deadline for manuscript submissions: closed (15 August 2024) | Viewed by 13777

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Dr. Ioannis Pantazopoulos

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Guest Editor

1. Assistant Professor, Department of Emergency Medicine, Faculty of Medicine, University of Thessaly, Biopolis, 41500 Larissa, Greece
2. Assistant Professor, Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, Biopolis, 41500 Larissa, Greece
Interests: respiratory intensive care; acute critical care; emergency medicine
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Konstantinos Gourgoulianis

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Guest Editor

Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Larissa, Greece
Interests: pleural effusion; COPD; asthma; interstitial lung diseases; pulmonary embolism; tuberculosis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The purpose of this Special Issue is to publish high-quality research papers, as well as review articles, to address the recent advances in respiratory diseases and emergency medicine. In particular, the topics of interest for this Special Issue include, but are not limited to, obstructive/restrictive/vascular/infectious respiratory diseases, emergency medicine, acute critical care, disaster medicine and related areas of experimental and clinical research in respiratory and emergency medicine. These topics also cover the following aspects:

Respiratory failure;
Non-invasive ventilation;
Nasal high-flow therapy;
Mechanical ventilation;
COPD;
Asthma;
Lung infections (COVID-19);
Pharmacology;
Cardiopulmonary resuscitation;
Toxicology;
Airway management;
Ultrasound in respiratory and emergency medicine.

Original, high-quality contributions that have not yet been published or that are not currently under review by another journal are welcome.

Dr. Ioannis Pantazopoulos
Prof. Dr. Konstantinos Gourgoulianis
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. Journal of Personalized Medicine is an international peer-reviewed open access monthly 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.

Keywords

respiratory research
respiratory care management
respiratory intensive care
acute respiratory diseases
chronic respiratory diseases
emergency medicine
acute critical care
disaster medicine
toxicology

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Published Papers (8 papers)

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11 pages, 550 KiB

Open AccessArticle

Clinical Characteristics and Prognosis of Older Patients with Coronavirus Disease 2019 Requiring Mechanical Ventilation

by Green Hong, Da Hyun Kang, Sunghoon Park, Su Hwan Lee, Onyu Park, Taehwa Kim, Hye Ju Yeo, Jin Ho Jang, Woo Hyun Cho and Song I Lee

J. Pers. Med. 2024, 14(6), 657; https://doi.org/10.3390/jpm14060657 - 19 Jun 2024

Viewed by 836

Abstract

An older age is associated with severe progression and poor prognosis in coronavirus disease 2019 (COVID-19), and mechanical ventilation is often required. The specific characteristics of older patients undergoing mechanical ventilation and their prognostic factors are largely unknown. We aimed to identify potential prognostic factors in this group to inform treatment decisions. This retrospective cohort study collected data from patients with COVID-19 at 22 medical centers. Univariate and multivariate Cox regression analyses were performed to assess factors that influence mortality. We allocated 434 patients in geriatric (≥80 years) and elderly (65–79 years) groups. The former group scored significantly higher than the elderly group in the clinical frailty scale and sequential organ failure assessment, indicating more severe organ dysfunction. Significantly lower administration rates of tocilizumab and extracorporeal membrane oxygenation and higher intensive care unit (ICU) and in-hospital mortality were noted in the geriatric group. The factors associated with ICU and in-hospital mortality included high creatinine levels, the use of continuous renal replacement therapy, prone positioning, and the administration of life-sustaining treatments. These results highlight significant age-related differences in the management and prognosis of critically ill older patients with COVID-19. Increased mortality rates and organ dysfunction in geriatric patients undergoing mechanical ventilation necessitate age-appropriate treatment strategies to improve their prognoses. Full article

(This article belongs to the Special Issue Respiratory and Emergency Medicine)

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11 pages, 784 KiB

Open AccessArticle

Incidence of Tracheal Stenosis in ICU Hospitalized COVID-19 Patients: Results from a Prospective, Observational, Multicenter Study

by Gianluca Perroni, Dejan Radovanovic, Michele Mondoni, Giuseppe Mangiameli, Veronica Maria Giudici, Alessandro Crepaldi, Valentina Giatti, Emanuela Morenghi, Giulia Maria Stella, Stefano Pavesi, Marco Mantero, Angelo Guido Corsico, Maura Spotti, Chiara Premuda, Stefano Attilio Mangili, Elisa Franceschi, Veronica Macioce Narvena, Nicolò Vanoni, Tommaso Pilocane, Gianluca Russo, Fabiano Di Marco, Marco Alloisio, Stefano Aliberti, Giuseppe Marulli, Alexia Francesca Bertuzzi, Giuseppe Cipolla, Stefano Centanni, Francesco Blasi, Pierachille Santus and Umberto Cariboni Show full author list Hide full author list

J. Pers. Med. 2024, 14(1), 39; https://doi.org/10.3390/jpm14010039 - 28 Dec 2023

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Abstract

Background: Tracheal stenosis represents a fearsome complication that substantially impairs quality of life. The recent SARS-CoV-2 pandemic increased the number of patients requiring invasive ventilation through prolonged intubation or tracheostomy, increasing the risk of tracheal stenosis. Study design and methods: In this prospective, observational, multicenter study performed in Lombardy (Italy), we have exanimated 281 patients who underwent prolonged intubation (more than 7 days) or tracheostomy for severe COVID-19. Patients underwent CT scan and spirometry 2 months after hospital discharge and a subsequent clinical follow-up after an additional 6 months (overall 8 months of follow-up duration) to detect any tracheal lumen reduction above 1%. The last follow-up evaluation was completed on 31 August 2022. Results: In the study period, 24 patients (8.5%, CI 5.6–12.4) developed tracheal stenosis in a median time of 112 days and within a period of 200 days from intubation. Compared to patients without tracheal stenosis, tracheostomy was performed more frequently in patients that developed stenosis (75% vs 54%, p = 0.034). Tracheostomy and alcohol consumption (1 unit of alcohol per day) increased risk of developing tracheal stenosis of 2.6-fold (p = 0.047; IC 0.99–6.8) and 5.4-fold (p = 0.002; CI 1.9–16), respectively. Conclusions: In a large cohort of patients, the incidence of tracheal stenosis increased during pandemic, probably related to the increased use of prolonged intubation. Patients with histories of prolonged intubation should be monitored for at least 200 days from invasive ventilation in order to detect tracheal stenosis at early stage. Alcohol use and tracheostomy are risk factors for developing tracheal stenosis. Full article

(This article belongs to the Special Issue Respiratory and Emergency Medicine)

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10 pages, 699 KiB

Open AccessArticle

Evaluation of the Acid–Base Status in Patients Admitted to the ICU Due to Severe COVID-19: Physicochemical versus Traditional Approaches

by Zoi Sotiropoulou, Elvira Markela Antonogiannaki, Evangelia Koukaki, Stavroula Zaneli, Agamemnon Bakakos, Angelos Vontetsianos, Nektarios Anagnostopoulos, Nikoleta Rovina, Konstantinos Loverdos, Paraskevi Tripolitsioti, Magdalini Kyriakopoulou, Konstantinos Pontikis, Petros Bakakos, Dimitrios Georgopoulos and Andriana I. Papaioannou

J. Pers. Med. 2023, 13(12), 1700; https://doi.org/10.3390/jpm13121700 - 11 Dec 2023

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Abstract

Background: Stewart’s approach is known to have better diagnostic accuracy for the identification of metabolic acid–base disturbances compared to traditional methods based either on plasma bicarbonate concentration ([HCO₃⁻]) and anion gap (AG) or on base excess/deficit (BE). This study aimed to identify metabolic acid–base disorders using either Stewart’s or traditional approaches in critically ill COVID-19 patients admitted to the ICU, to recognize potential hidden acid–base metabolic abnormalities and to assess the prognostic value of these abnormalities for patient outcome. Methods: This was a single-center retrospective study, in which we collected data from patients with severe COVID-19 admitted to the ICU. Electronical files were used to retrieve data for arterial blood gases, serum electrolytes, and proteins and to derive [HCO₃⁻], BE, anion gap (AG), AG adjusted for albumin (AG_adj), strong ion difference, strong ion gap (SIG), and SIG corrected for water excess/deficit (SIG_corr). The acid–base status was evaluated in each patient using the BE, [HCO₃⁻], and physicochemical approaches. Results: We included 185 patients. The physicochemical approach detected more individuals with metabolic acid–base abnormalities than the BE and [HCO₃⁻] approaches (p < 0.001), and at least one acid–base disorder was recognized in most patients. According to the physicochemical method, 170/185 patients (91.4%) had at least one disorder, as opposed to the number of patients identified using the BE 90/186 (48%) and HCO₃ 62/186 (33%) methods. Regarding the derived acid–base status variables, non-survivors had greater AG_adj, (p = 0.013) and SIG_corr (p = 0.035) compared to survivors. Conclusions: The identification of hidden acid–base disturbances may provide a detailed understanding of the underlying conditions in patients and of the possible pathophysiological mechanisms implicated. The association of these acid–base abnormalities with mortality provides the opportunity to recognize patients at increased risk of death and support them accordingly. Full article

(This article belongs to the Special Issue Respiratory and Emergency Medicine)

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11 pages, 873 KiB

Open AccessArticle

A Hypertonic Seawater Nasal Irrigation Solution Containing Algal and Herbal Natural Ingredients Reduces Viral Load and SARS-CoV-2 Detection Time in the Nasal Cavity

by Ioannis Pantazopoulos, Athanasios Chalkias, Angeliki Miziou, Michalis Spanos, Efrosyni Gerovasileiou, Erasmia Rouka and Konstantinos Gourgoulianis

J. Pers. Med. 2023, 13(7), 1093; https://doi.org/10.3390/jpm13071093 - 3 Jul 2023

Cited by 4 | Viewed by 3077

Abstract

Nasal irrigation is thought to decrease the viral load present in the nasal cavity. Our aim was to assess the effect of a hypertonic seawater solution [with algal and herbal natural ingredients (Sinomarin^®)] on the viral load of nasopharynx in patients hospitalized with severe COVID-19 pneumonia. We conducted a prospective, randomized, controlled trial from June 2022 to December 2022. We allocated 56 patients with COVID-19 pneumonia into two groups (28 in each group)—the hypertonic seawater group [nasal irrigations with a hypertonic seawater solution (Sinomarin^®) every 4 h for 16 h per day, for two consecutive days] and the control group (no nasal irrigations). A second nasopharyngeal swab was collected 48 h after the baseline nasopharyngeal swab (8 h after the last wash in the hypertonic seawater group) to estimate the SARS-CoV-2 viral load as determined by cycle threshold (Ct) values. In the hypertonic seawater group, the mean Ct values significantly increased two days after the initial measurement [ΔCt 48−0 h = 3.86 ± 3.03 cycles, p < 0.001 (95%CI: 2.69 to 5.04)]. No significant differences in the Ct values were observed in the control group [ΔCt 48−0 h = −0.14 ± 4.29, p = 0.866 (95%CI: −1.80 to −1.52)]. At follow-up, 17 patients from the hypertonic seawater group had negative test results compared to only 9 patients from the control group (p = 0.03). Nasal irrigations with a hypertonic seawater solution containing algal and herbal natural ingredients significantly decreased nasopharyngeal viral load and the detection time of SARS-CoV-2 in the nasal cavity. Full article

(This article belongs to the Special Issue Respiratory and Emergency Medicine)

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12 pages, 1830 KiB

Open AccessArticle

The Relation of Calculated Plasma Volume Status to Sublingual Microcirculatory Blood Flow and Organ Injury

by Eleni Laou, Nikolaos Papagiannakis, Nicoletta Ntalarizou, Theodora Choratta, Zacharoula Angelopoulou, Konstantinos Annousis, Minas Sakellakis, Aikaterini Kyriakaki, Dimitrios Ragias, Anastasia Michou and Athanasios Chalkias

J. Pers. Med. 2023, 13(7), 1085; https://doi.org/10.3390/jpm13071085 - 30 Jun 2023

Cited by 2 | Viewed by 1191

Abstract

Background: The calculated plasma volume status (cPVS) was validated as a surrogate of intravascular filling. The aim of this study is to assess the cPVS in relation to sublingual perfusion and organ injury. Methods: Pre- and postoperative cPVS were obtained by determining the actual and ideal plasma volume levels in surgical patients. The sublingual microcirculation was assessed using SDF imaging, and we determined the De Backer score, the Consensus Proportion of Perfused Vessels (Consensus PPV), and the Consensus PPV (small). Our primary outcome was the assessment of the distribution of cPVS and its association with intraoperative sublingual microcirculation and postoperative complications. Results: The median pre- and postoperative cPVS were −7.25% (IQR −14.29–−1.88) and −0.4% (IQR −5.43–6.06), respectively (p < 0.001). The mean intraoperative administered fluid volume was 2.5 ± 2.5 L (1.14 L h⁻¹). No statistically significant correlation was observed between the pre- or postoperative cPVS and sublingual microcirculation variables. Higher preoperative (OR = 1.04, p = 0.098) and postoperative cPVS (OR = 1.057, p = 0.029) were associated with postoperative organ injury and complications (sepsis (30%), anemia (24%), respiratory failure (13%), acute kidney injury (6%), hypotension (6%), stroke (3%)). Conclusions: The calculated PVS was associated with an increased risk of organ injury and complications in this cohort. Full article

(This article belongs to the Special Issue Respiratory and Emergency Medicine)

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13 pages, 1023 KiB

Open AccessArticle

Scoring Systems to Evaluate the Mortality Risk of Patients with Emphysematous Cystitis: A Retrospective Observational Study

by Yi-Hsuan Chen, Ming-Shun Hsieh, Sung-Yuan Hu, Shih-Che Huang, Che-An Tsai and Yi-Chun Tsai

J. Pers. Med. 2023, 13(2), 318; https://doi.org/10.3390/jpm13020318 - 13 Feb 2023

Cited by 2 | Viewed by 2208

Abstract

Background: Emphysematous cystitis (EC) is a complicated urinary tract infection (UTI) characterized by gas formation within the bladder wall and lumen. Immunocompetent people are less likely to suffer from complicated UTIs, but EC usually occurs in women with poorly controlled diabetes mellitus (DM). Other risk factors of EC include recurrent UTI, neurogenic bladder disorder, blood supply disorders, and prolonged catheterization, but DM is still the most important of all aspects. Our study investigated clinical scores in predicting clinical outcomes of patients with EC. Our analysis is unique in predicting EC clinical outcomes by using scoring system performance. Materials and Methods: We retrospectively collected EC patient data from the electronic clinical database of Taichung Veterans General Hospital between January 2007 and December 2020. Urinary cultures and computerized tomography confirmed EC. In addition, we investigated the demographics, clinical characteristics, and laboratory data for analysis. Finally, we used a variety of clinical scoring systems as a predictor of clinical outcomes. Results: A total of 35 patients had confirmed EC, including 11 males (31.4%) and 24 females (68.6%), with a mean age of 69.1 ± 11.4 years. Their hospital stay averaged 19.9 ± 15.5 days. The in-hospital mortality rate was 22.9%. The Mortality in Emergency Department Sepsis (MEDS) score was 5.4 ± 4.7 for survivors and 11.8 ± 5.3 for non-survivors (p = 0.005). For mortality risk prediction, the AUC of ROC was 0.819 for MEDS and 0.685 for Rapid Emergency Medicine Score (REMS). The hazard ratio of univariate and multivariate logistic regression analyses of REMS for EC patients was1.457 (p = 0.011) and 1.374 (p = 0.025), respectively. Conclusion: Physicians must pay attention to high-risk patients according to clinical clues and arrange imaging studies as soon as possible to confirm the diagnosis of EC. MEDS and REMS are helpful for clinical staff in predicting the clinical outcome of EC patients. If EC patients feature higher scores of MEDS (≥12) and REMS (≥10), they will have higher mortality. Full article

(This article belongs to the Special Issue Respiratory and Emergency Medicine)

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6 pages, 1197 KiB

Open AccessCase Report

Recurrent Echinococcosis Exhibiting Hydatoptysis: A Rare Case with Imaging Insights

by Maria Konstantinidou, Eleni D. Eleftheriadou, Effimia Kamariotou, Christina Rampiadou, Styliani Papaemmanouil and Diamantis Chloros

J. Pers. Med. 2024, 14(8), 796; https://doi.org/10.3390/jpm14080796 - 27 Jul 2024

Viewed by 846

Abstract

Echinococcosis presents diverse clinical manifestations, including pulmonary hydatidosis, often asymptomatic but complicated by rare yet dramatic occurrences like hydatoptysis. Here, we report a unique case of recurrent pulmonary and abdominal hydatidosis in a 59-year-old female with bronchial fistulization and hydatoptysis, despite previous surgical interventions. Imaging revealed characteristic features aiding in diagnosis and management decisions. The challenges in managing recurrent echinococcosis underscore the importance of comprehensive follow-up and multidisciplinary care. Surgical intervention remains pivotal, supplemented by medical therapy with careful consideration of risks and benefits. This case also presents rare images, absent in much of the literature, which provide valuable insights into the disease’s presentation and progression. Full article

(This article belongs to the Special Issue Respiratory and Emergency Medicine)

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13 pages, 1552 KiB

Open AccessSystematic Review

Chronic Obstructive Pulmonary Disease Mortality and Hospitalization during the COVID-19 Pandemic Compared with before the Pandemic: A Systematic Review and Meta-Analysis

by Chiwon Ahn and Yeonkyung Park

J. Pers. Med. 2024, 14(3), 296; https://doi.org/10.3390/jpm14030296 - 10 Mar 2024

Viewed by 1437

Abstract

This study aimed to assess the impact of the pandemic on hospitalization and mortality rates among patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We conducted a systematic search across three medical databases for studies comparing the AECOPD mortality and hospitalization rates during the COVID-19 pandemic with those before the pandemic, up until December 2023. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology guidelines, we performed a meta-analysis with a random-effects model to pool odds ratios (ORs), 95% confidence intervals (CIs), and heterogeneity (I²). From 4689 records, 21 studies met our inclusion criteria. Our analysis revealed a significant increase in in-hospital mortality during the pandemic (pooled OR = 1.27, 95% CI = 1.17–1.39, I² = 50%). Subgroup analysis highlighted a more pronounced mortality risk in single-center studies and smaller populations. Conversely, hospitalization rates for AECOPD significantly declined during the pandemic (pooled OR = 0.39, 95% CI = 0.18–0.85, I² = 99%). The study demonstrates that during the COVID-19 pandemic, there was a substantial decrease in hospital admissions for AECOPD and an increase in in-hospital deaths. This shows that better healthcare plans and pandemic preparedness are needed to help people with chronic conditions. Full article

(This article belongs to the Special Issue Respiratory and Emergency Medicine)

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