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Diagnostics
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Pulmonary Disease: Diagnosis and Management
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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 8356

Special Issue Editor

Dr. Byung Woo Jhun

E-Mail Website
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
Special Issues, Collections and Topics in MDPI journals

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

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.

Keywords

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

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Published Papers (6 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
Viewed by 1528
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
Viewed by 1086
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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28 pages, 1562 KiB  
Review
A Practical Multidisciplinary Approach to Identifying Interstitial Lung Disease in Systemic Autoimmune Rheumatic Diseases: A Clinician’s Narrative Review
by Viorel Biciusca, Anca Rosu, Sorina Ionelia Stan, Ramona Cioboata, Teodora Biciusca, Mara Amalia Balteanu, Cristina Florescu, Georgiana Cristiana Camen, Ovidiu Cimpeanu, Ana Maria Bumbea, Mihail Virgil Boldeanu and Simona Banicioiu-Covei
Diagnostics 2024, 14(23), 2674; https://doi.org/10.3390/diagnostics14232674 - 27 Nov 2024
Abstract
Interstitial lung disease (ILD) is one of the common and potentially lethal manifestations of systemic autoimmune rheumatic diseases (SARDs). ILD’s prevalence, clinical patterns, imaging, and natural history are variable. Each of the representative diseases—systemic sclerosis (SSc), idiopathic inflammatory myopathies (IIMs), rheumatoid arthritis (RA), [...] Read more.
Interstitial lung disease (ILD) is one of the common and potentially lethal manifestations of systemic autoimmune rheumatic diseases (SARDs). ILD’s prevalence, clinical patterns, imaging, and natural history are variable. Each of the representative diseases—systemic sclerosis (SSc), idiopathic inflammatory myopathies (IIMs), rheumatoid arthritis (RA), Sjӧgren’s syndrome (SjS), mixed connective tissue disease (MCTD), systemic lupus erythematosus (SLE)—have distinct clinical, paraclinical and evolutionary features. Risk factors with predictive value for ILD have been identified. This review summarizes, from the clinician’s perspective, recent data from the literature regarding the specificity of ILD for each of the autoimmune rheumatic diseases, with an emphasis on the role of the multidisciplinary team in early diagnosis, case management, as well as the particularities of the clinical approach to the progressive phenotype of ILD in SARDs. Full article
(This article belongs to the Special Issue Pulmonary Disease: Diagnosis and Management)
17 pages, 767 KiB  
Review
Pulmonary Embolism in Critically Ill Patients—Prevention, Diagnosis, and Management
by Charikleia S. Vrettou, Effrosyni Dima and Ioanna Sigala
Diagnostics 2024, 14(19), 2208; https://doi.org/10.3390/diagnostics14192208 - 3 Oct 2024
Viewed by 1726
Abstract
Critically ill patients in the intensive care unit (ICU) are often immobilized and on mechanical ventilation, placing them at increased risk for thromboembolic diseases, particularly deep vein thrombosis (DVT) and, to a lesser extent, pulmonary embolism (PE). While these conditions are frequently encountered [...] Read more.
Critically ill patients in the intensive care unit (ICU) are often immobilized and on mechanical ventilation, placing them at increased risk for thromboembolic diseases, particularly deep vein thrombosis (DVT) and, to a lesser extent, pulmonary embolism (PE). While these conditions are frequently encountered in the emergency department, managing them in the ICU presents unique challenges. Although existing guidelines are comprehensive and effective, they are primarily designed for patients presenting with PE in the emergency department and do not fully address the complexities of managing critically ill patients in the ICU. This review aims to summarize the available data on these challenging cases, offering a practical approach to the prevention, diagnosis, and treatment of PE, particularly when it is acquired in the ICU. Full article
(This article belongs to the Special Issue Pulmonary Disease: Diagnosis and Management)
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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
Viewed by 2660
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)

Other

Jump to: Research, Review

13 pages, 10026 KiB  
Case Report
Novel Treatment for Pre-XDR Tuberculosis Linked to a Lethal Case of Acute Myocarditis
by Serafeim-Chrysovalantis Kotoulas, Pavlos Poulios, Georgia Chasapidou, Elena Angeloudi, Triantafyllenia Bargiota, Maria Stougianni, Katerina Manika and Eleni Mouloudi
Diagnostics 2024, 14(19), 2139; https://doi.org/10.3390/diagnostics14192139 - 26 Sep 2024
Cited by 1 | Viewed by 666
Abstract
The management of resistant tuberculosis (tb) can be extremely difficult, especially in case of novel unpredicted complications. In this report, we present a case of a 48-year-old patient with pre-extensively drug-resistant (XDR) tb who received a treatment regimen including pretomanid, bedaquiline, linezolid, cycloserine, [...] Read more.
The management of resistant tuberculosis (tb) can be extremely difficult, especially in case of novel unpredicted complications. In this report, we present a case of a 48-year-old patient with pre-extensively drug-resistant (XDR) tb who received a treatment regimen including pretomanid, bedaquiline, linezolid, cycloserine, and amikacin and died due to myocarditis. Acquired resistance to first- and second-line drugs developed due to previous poor adherence to medication. The clinical presentation of the patient, along with her initial ultrasonographical, electrocardiogram (ECG), and laboratory examinations, were typical for acute myocarditis; however, the patient was considered unstable, and further investigations, including magnetic resonance imaging (MRI), pericardiocentesis, and endomyocardial biopsy were not performed. To our knowledge, this is the first case of myocarditis in such a patient, the clinical features of which raised a high suspicion of drug induction that could be attributed to the treatment regimen that was administered. Clinicians who manage cases of drug-resistant tb should be aware of this newly reported, potentially lethal, adverse event. Full article
(This article belongs to the Special Issue Pulmonary Disease: Diagnosis and Management)
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