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

Deadline for manuscript submissions: 30 April 2024 | Viewed by 10370

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Special Issue Editors

Dr. Radu Adrian Crisan-Dabija

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Guest Editor

1. Faculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, Romania
2. Pulmonology Department, Clinic of Pulmonary Diseases, 700115 Iasi, Romania
Interests: biomarkers; COPD; AI; viral infections; COVID-19; interstitial lung diseases; sarcoidosis; diagnostic errors; improvement science

Dr. Alexandru Burlacu

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Guest Editor

1. Institute of Cardiovascular Diseases “Prof. Dr. George I.M. Georgescu”, 700503 Iasi, Romania
2. Faculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, Romania
3. Medical Sciences Academy, 030167 Bucharest, Romania
Interests: cardionephrology; AI; chronical respiratory diseases; gut microbiota; interventional cardiology; research methodology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to announce this Special Issue where we invite professionals to submit their valuable work regarding chronic respiratory diseases and their dangerous body-wide implications. We aim to deliver outstanding research data and general, narrative, or systematic reviews. An interdisciplinary approach, in the era of “Medicine 2.0”, where the final diagnostic always belongs to a team and not to a single healthcare professional, asks for a multi-point perspective of diagnostic and treatment options.

We aim to deliver an integrated collection of researchers’ work that, we hope, will bring insight into interdisciplinarity in the management of respiratory diseases. We focus on the close relationship between pulmonary diseases and cardiac involvement, state-of-the-art diagnostic tools, diagnostic errors and modern approaches to “old” respiratory diseases, respecting the scientific novelties in the fields of interstitial lung diseases and modern assessment tools.

Dr. Radu Adrian Crisan-Dabija
Dr. Alexandru Burlacu
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

biomarkers
heart-rate variability
gut microbiota
pulmonary arterial hypertension
pulmonary microbiome
sleep apnea
sarcoidosis
obesity-hypoventilation
pediatric respiratory diseases
lung cancer
interleukins
bronchial lavage
lung inflammation
thoracic surgery
survival analysis
interstitial lung disease

Published Papers (9 papers)

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Research

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16 pages, 1282 KiB

Open AccessArticle

The Effect of Comorbidities and Complications on COVID-19 Mortality: A Detailed Retrospective Study in Western Romania

by Monica Steluta Marc, Daniela Rosca, Felix Bratosin, Ovidiu Fira-Mladinescu, Cristian Oancea, Camelia Corina Pescaru, Diana Velescu, Norbert Wellmann, Alexandru Catalin Motofelea, Ioana Mihaiela Ciuca, Karina Saracin and Diana Manolescu

J. Pers. Med. 2023, 13(11), 1552; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13111552 - 29 Oct 2023

Cited by 1 | Viewed by 1033

Abstract

COVID-19 continues to impact global health systems even after being declared over, with some patients exhibiting severe complications linked to pre-existing conditions. This study aimed to investigate the association between comorbidities, complications, and survival outcomes among COVID-19 survivors in Western Romania. Our hypothesis posited that comorbidities and complications significantly influence survival rates. We conducted a retrospective analysis of 1948 COVID-19 survivors admitted from January to December 2021, with 192 selected for detailed analysis based on inclusion and exclusion criteria. The severity of COVID-19 was classified according to WHO guidelines, and conditions like hypertension and obesity were defined using criteria from the European Society of Hypertension (ESH), the European Society of Cardiology (ESC), and WHO, respectively. Among the 192 patients, 33 had mild, 62 had moderate, and 97 had severe COVID-19. The median age across the severity groups was 63.2 years. Patients undergoing tracheostomy had a mortality rate of 83.3% versus 22.2% for non-tracheostomy patients (p < 0.001) and presented with significantly higher lung injury, hospitalization duration, and complications. Remarkably, tracheostomized patients were 17.50 times more likely to succumb to the disease (95% CI 4.39–116.91, p < 0.001). Furthermore, pneumothorax increased the mortality risk significantly (OR 22.11, 95% CI 5.72–146.03, p < 0.001). Intriguingly, certain conditions like grade I hypertension and grade II obesity showed a protective effect against mortality, whereas type 2 diabetes mellitus increased mortality risk (univariate OR 2.89, p = 0.001). The presence of certain comorbidities and complications significantly impacts the survival rates of COVID-19 patients in Western Romania. Notably, tracheostomy, pneumothorax, and T2DM were associated with increased mortality. This study underscores the importance of personalized patient care and provides insights for healthcare policymakers in Western Romania to improve clinical management strategies. Full article

(This article belongs to the Special Issue Respiratory Health and Chronic Disease Management)

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16 pages, 1350 KiB

Open AccessArticle

Airborne Particulate Matter Size and Chronic Obstructive Pulmonary Disease Exacerbations: A Prospective, Risk-Factor Analysis Comparing Global Initiative for Obstructive Lung Disease 3 and 4 Categories

by Gabriel-Petrică Bălă, Ovidiu Rosca, Felix Bratosin, Uday Shree Akkala Shetty, Sai Diksha Vutukuru, Isabella-Ionela Sanda, Monica Marc, Ovidiu Fira-Mladinescu and Cristian Oancea

J. Pers. Med. 2023, 13(10), 1505; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13101505 - 18 Oct 2023

Viewed by 1245

Abstract

Current research primarily emphasizes the generalized correlations between airborne pollution and respiratory diseases, seldom considering the differential impacts of particular particulate matter sizes on chronic obstructive pulmonary disease (COPD) exacerbations in distinct Global Initiative for Obstructive Lung Disease (GOLD) categories. This study hypothesizes a critical association between particulate matter sizes (PM 1.0, PM 2.5, and PM 10) and exacerbation frequency in COPD patients categorized under GOLD 3 and GOLD 4, with a potential augmenting role played by proximity to main roads and industrial areas. This research aspires to offer a nuanced perspective on the exacerbation patterns in these groups, setting the stage for targeted intervention strategies. Utilizing a prospective design, this study followed 79 patients divided into GOLD 3 (n = 47) and GOLD 4 (n = 32) categories. The participants were monitored for ten days for daily activity levels, symptoms, living conditions, and airborne particulate matter concentrations, with spirometric evaluations employed to measure lung function. Statistical analyses were used to identify potential risk factors and significant associations. The analysis revealed substantial disparities in airborne particulate matter sizes between the two groups. The mean PM 1.0 concentration was notably higher in GOLD 4 patients (26 µg/m³) compared to GOLD 3 patients (18 µg/m³). Similarly, elevated PM 2.5 levels were observed in the GOLD 4 category (35 µg/m³) in contrast to the GOLD 3 category (24 µg/m³). A vital finding was the increased frequency of exacerbations in individuals residing within 200 m of main roads compared to those living further away (OR = 2.5, 95% CI: 1.5–4.1). Additionally, patients residing in homes smaller than 50 square meters demonstrated a greater frequency of exacerbations. Spirometry results corroborated the exacerbated condition in GOLD 4 patients, indicating a significant decline in lung function parameters compared to the GOLD 3 group. This study substantiates a significant association between airborne particulate matter sizes and exacerbation frequencies in COPD patients, particularly accentuating the increased risk in GOLD 4 patients. Our findings underscore the pivotal role of environmental factors, including the size of living areas and proximity to main roads, in influencing COPD exacerbations. These results suggest the need for personalized healthcare strategies and interventions, which account for environmental risk factors and the distinctions between GOLD 3 and GOLD 4 categories of COPD patients. Full article

(This article belongs to the Special Issue Respiratory Health and Chronic Disease Management)

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18 pages, 2497 KiB

Open AccessArticle

HPLC Analysis and Risk Assessment of 15 Priority PAHs in Human Blood Serum of COPD Patient from Urban and Rural Areas, Iasi (Romania)

by Ioana Buculei, Mona Elisabeta Dobrin, Daniela Matei, Ilie Onu, Ionel Bogdan Cioroiu, Bogdan Caba, Mădălina-Gabriela Postelnicu, Dragos-Horia Buhociu, Carmina Liana Musat, Radu Crisan-Dabija, Andrei Tudor Cernomaz and Antigona Carmen Trofor

J. Pers. Med. 2023, 13(9), 1290; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13091290 - 23 Aug 2023

Viewed by 1313

Abstract

One of the leading risk factors for environmental health problems is air pollution. The World Health Organization (WHO) reports that this risk factor is associated with one of every nine deaths worldwide. Epidemiological studies conducted in this field have shown a solid connection between respiratory pathology and polycyclic aromatic hydrocarbon (PAH) exposure. COPD and asthma are respiratory diseases that were shown to have a strong association with exposure to PAHs. The purpose of the present study was to assess the serum levels of 15 PAHs in 102 COPD patients and to evaluate the results according to the residence environment of the investigated subjects. Analyses were carried out using a high-performance liquid chromatograph Nexera X2—Shimadzu Japan, which was equipped with an LC–30AD pump and an SIL–30AC autosampler. Spiked matrices, procedure blanks, spiked controls, and calibration standards in the acetonitrile were used as quality-assurance samples. Benzo(a)pyrene is the main representative of PAHs and was determined in higher concentrations in subjects with COPD versus the control group from the urban area (0.90/0.47 ng/mL) and rural area (0.73/0.44 ng/mL). The values obtained for the Benzo(a)pyrene-equivalent factor indicate a higher carcinogenic potential for patients diagnosed with COPD in urban areas compared to those in rural areas. These results could be due to traffic and vehicle emissions. This research identifies the need for legislative action to decrease semi-volatile organic compounds, especially PAHs, mainly in urban cities, in order to improve environmental management and health conditions. Full article

(This article belongs to the Special Issue Respiratory Health and Chronic Disease Management)

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15 pages, 2096 KiB

Open AccessArticle

The Inflammatory Profile Correlates with COVID-19 Severity and Mortality in Cancer Patients

by Corina Eugenia Budin, Alexandra Floriana Nemeș, Ruxandra-Mioara Râjnoveanu, Roxana Maria Nemeș, Armand Gabriel Rajnoveanu, Adrian Horațiu Sabău, Iuliu Gabriel Cocuz, Răzvan Gheorghita Mareș, Vlad Iustinian Oniga, Dariana Elena Pătrîntașu and Ovidiu Simion Cotoi

J. Pers. Med. 2023, 13(8), 1235; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13081235 - 07 Aug 2023

Viewed by 905

Abstract

Background: The correlation of the inflammatory profile with the severity of the disease in neoplastic patients with SARS-CoV-2 infection was addressed. Methods: A database of 1537 patients hospitalized in the pneumology department was analyzed. After applying the inclusion and exclusion criteria, 83 patients (67% males, 33% females) were included. Results: Most of the analyzed patients were hospitalized with a moderate form of disease, explaining the significant percentage of 25% mortality. The frequency of the type of neoplasm was higher for lung cancer, followed by malignant colon tumor. We identified a significant association between the increased value of ferritin (p < 0.0001, OR = 22.31), fibrinogen (p = 0.009, OR = 13.41), and C-reactive protein (p = 0.01, OR = 7.65), respectively, and the level of severity of COVID-19. The results of the univariate logistic regression analysis for predicting the severity of the disease revealed that the increased values of ferritin (p = 0.001, OR = 22.31) and fibrinogen (p = 0.02, OR = 13.41) represent a risk for a serious negative prognosis of COVID-19. Conclusions: Our study demonstrated that the value of the analyzed inflammatory parameters increased in direct proportion to the severity of the disease and that higher values were associated with increased mortality in the study group. Full article

(This article belongs to the Special Issue Respiratory Health and Chronic Disease Management)

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12 pages, 891 KiB

Open AccessArticle

Longitudinal Analysis of Pulmonary Function Impairment One Year Post-COVID-19: A Single-Center Study

by Noemi Suppini, Ovidiu Fira-Mladinescu, Daniel Traila, Alexandru Catalin Motofelea, Monica Steluta Marc, Diana Manolescu, Emanuela Vastag, Ram Kiran Maganti and Cristian Oancea

J. Pers. Med. 2023, 13(8), 1190; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13081190 - 26 Jul 2023

Cited by 1 | Viewed by 1072

Abstract

Persistent pulmonary impairment post-COVID-19 has been reported, albeit variably. This single-center observational study aims to longitudinally evaluate pulmonary function in 140 COVID-19 survivors one year after recovery, assessing associations with disease severity and pre-existing lung conditions. Participants aged 18 and older, with confirmed SARS-CoV-2 infection, were evaluated using spirometry and Diffusion Capacity of Lungs for Carbon Monoxide (DLCO) tests. Pulmonary function parameters like Forced Expiratory Volume at 1 s (FEV1), Forced Vital Capacity (FVC), and Total Lung Capacity (TLC) were measured. Participants were stratified by age, gender, body mass index, smoking status, and lung damage severity via computed tomography (CT). The cohort consisted of mostly males (58.6%), with a mean age of 53.8 years and body mass index of 24.9 kg/m². Post-COVID fibrosis was seen in 22.7%, 27.3%, and 51.9% of mild, moderate, and severe disease patients, respectively (p = 0.003). FVC significantly reduced with disease severity (p < 0.001), while FEV1, FEF25-75, and DLCO showed a non-significant downward trend. FEV1/FVC ratio increased with disease severity (p = 0.033), and TLC and RV significantly declined (p = 0.023 and p = 0.003, respectively). A one-year follow-up indicated a non-significant change in FVC, FEV1, FEV1/FVC ratio, FEF25-75, and RV compared with the 40-day measurement, but it revealed significant improvements in DLCO and TLC (p = 0.010). There were significant mean increases in FVC, FEV1, DLCO, TLC, and RV across all disease severities over one year. They were most pronounced in the patients with a history of severe COVID-19, who had a better recovery over one year, compared with the mild and moderate COVID-19 patients whose lung function almost normalized. One year after the SARS-CoV-2 infection, we observed a significant association between disease severity and post-COVID fibrotic changes. Though some lung function parameters remained stable over the year, significant improvements were noted in DLCO and TLC. Particularly, individuals with severe disease showed substantial recovery in lung function, indicating the potential reversibility of COVID-19-related pulmonary damage. Full article

(This article belongs to the Special Issue Respiratory Health and Chronic Disease Management)

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15 pages, 706 KiB

Open AccessArticle

Serum and Bronchoalveolar Lavage Fluid Levels of Cytokines in Patients with Lung Cancer and Chronic Lung Disease: A Prospective Comparative Study

by Patricia Hogea, Emanuela Tudorache, Ovidiu Fira-Mladinescu, Monica Marc, Diana Velescu, Diana Manolescu, Felix Bratosin, Ovidiu Rosca, Adelina Mavrea and Cristian Oancea

J. Pers. Med. 2023, 13(6), 998; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13060998 - 14 Jun 2023

Cited by 1 | Viewed by 1193

Abstract

The role of chronic inflammation in the initiation and progression of carcinogenesis has been well-established in previous studies, particularly in the stages of malignant conversion, invasion, and metastasis. This study aimed to explore the potential correlation between the levels of cytokines in serum and bronchoalveolar lavage fluid (BALF) by comparing their levels between patients with lung cancer and those with benign lung diseases. The study measured the concentration of IFN-γ, TNF-α, IL-1β, IL-2, IL-4, IL-6, IL-10, and IL-12p70, in venous blood and BALF of a total of 33 patients with lung cancer and 33 patients with benign lung diseases. Significant differences were found between the two groups in various clinical parameters. The cytokine levels were significantly higher among patients with malignant disease, while the BALF analysis revealed higher cytokine levels compared with serum analysis. It was discovered that the levels of cancer-specific cytokines in the lavage fluid increased significantly sooner and were present at a greater concentration than those in the peripheral blood. After one month of treatment, the serum markers decreased significantly but slower in the lavage fluid. The differences between serum and BALF markers remained significant. It was observed that the highest correlation was among IL-6 (serum) and IL-6 (lavage), with a coefficient of 0.774 (p-value < 0.001), and IL-1 (serum) and IL-1β (lavage), with a coefficient value of 0.610 (p-value < 0.001). Other significant correlations among serum and lavage cytokines were observed between IL-6 (lavage) and IL-1 (serum) (rho = 0.631, p-value < 0.001) and CRP (rho = 0.428, p-value = 0.001), respectively. This study revealed significant differences and correlations in clinical parameters, serum markers, and BALF inflammatory markers between patients with lung cancer and those with benign lung pathologies. The results highlight the importance of understanding the inflammatory profiles of these conditions and could contribute to the development of targeted therapies or diagnostic approaches in the future. Further research is needed to validate these findings, explore their implications for clinical practice, and determine the diagnostic and prognostic value of these cytokines for lung cancer. Full article

(This article belongs to the Special Issue Respiratory Health and Chronic Disease Management)

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13 pages, 1285 KiB

Open AccessArticle

The Association of IFN-γ, TNF-α, and Interleukins in Bronchoalveolar Lavage Fluid with Lung Cancer: A Prospective Analysis

by Patricia Hogea, Emanuela Tudorache, Ovidiu Fira-Mladinescu, Monica Marc, Diana Manolescu, Felix Bratosin, Ovidiu Rosca, Adelina Mavrea and Cristian Oancea

J. Pers. Med. 2023, 13(6), 968; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13060968 - 08 Jun 2023

Cited by 1 | Viewed by 1066

Abstract

Lung cancer is a leading cause of cancer-related mortality worldwide. Identifying novel diagnostic and prognostic biomarkers is essential for improving patient outcomes. This study aimed to investigate the predictive role of cytokines from bronchoalveolar lavage fluid (BALF) in lung cancer diagnosis and prognosis. A prospective study was conducted on 33 patients with suspected lung cancer, divided into inflammatory and non-inflammatory BALF groups. Inflammatory markers in BALF were assessed, and their association with lung cancer risk was analyzed using receiver operating characteristic (ROC) plot analysis, sensitivity and specificity percentages, and regression analysis. Statistically significant differences were observed between the inflammatory and non-inflammatory groups for several inflammatory markers, including IFN-gamma, IL-1b, IL-2, IL-6, IL-10, and IL-12p70. In the follow-up analysis, significant differences persisted for IFN-gamma, IL-1b, IL-2, IL-4, and IL-6. ROC plot analysis revealed that IL-12p70 had the highest area under the curve (AUC) value (0.702), followed by IL-2 (0.682), IL-6 (0.620), IL-4 (0.611), TNF-alpha (0.609), IL-10 (0.604), IL-1b (0.635), and IFN-gamma (0.521). IL-6 showed the highest sensitivity (73%), and IL-1b had the highest specificity (69%). Regression analysis demonstrated that IL-6 (cut-off = 25 pg/mL) and IL-12p70 (cut-off = 30 pg/mL) had the highest odds ratios for lung cancer risk, at 5.09 (95% CI: 2.38–9.24, p < 0.001) and 4.31 (95% CI: 1.85–8.16, p < 0.001), respectively. Cytokines from BALF, particularly IL-6 and IL-12p70, show potential as diagnostic and prognostic biomarkers for lung cancer. Further studies with larger cohorts are warranted to confirm these findings and elucidate the clinical implications of these markers in lung cancer management. Full article

(This article belongs to the Special Issue Respiratory Health and Chronic Disease Management)

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Review

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10 pages, 280 KiB

Open AccessReview

Speaking of the “Devil”: Diagnostic Errors in Interstitial Lung Diseases

by Raluca Ioana Arcana, Radu Adrian Crișan-Dabija, Bogdan Caba, Alexandra-Simona Zamfir, Tudor Andrei Cernomaz, Andreea Zabara-Antal, Mihai Lucian Zabara, Ștefăniță Arcana, Dragoș Traian Marcu and Antigona Trofor

J. Pers. Med. 2023, 13(11), 1589; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13111589 - 10 Nov 2023

Viewed by 825

Abstract

Interstitial lung diseases are respiratory diseases, which affect the normal lung parenchyma and can lead to significant pulmonary fibrosis, chronic respiratory failure, pulmonary hypertension, and ultimately death. Reuniting more than 200 entities, interstitial lung diseases pose a significant challenge to the clinician, as they represent rare diseases with vague and insidious respiratory symptoms. As such, there are many diagnostic errors that can appear along the journey of the patient with ILD, which leads to significant delays with implications for the prognosis and the quality of life of the patient. Full article

(This article belongs to the Special Issue Respiratory Health and Chronic Disease Management)

13 pages, 249 KiB

Open AccessReview

A Debate on Surgical and Nonsurgical Approaches for Obstructive Sleep Apnea: A Comprehensive Review

by Andreea Zabara-Antal, Ionela Grosu-Creanga, Mihai Lucian Zabara, Andrei Tudor Cernomaz, Bogdan Mihnea Ciuntu, Oana Melinte, Cristian Lupascu and Antigona Carmen Trofor

J. Pers. Med. 2023, 13(9), 1288; https://0-doi-org.brum.beds.ac.uk/10.3390/jpm13091288 - 23 Aug 2023

Viewed by 1019

Abstract

Regular and unobstructed breathing during the night is the prerequisite for an undisturbed and restful sleep. The most prevalent nocturnal breathing disturbance with morbid consequences is obstructive sleep apnea syndrome. The prevalence of obstructive sleep apnea (OSA) is increasing, and a significant number of patients with OSA are undiagnosed. On the other hand, the “obesity epidemic” is a growing concern globally. A sleep test is required to diagnose sleep apnea and to individualize therapy. A multidisciplinary approach is the key to success. This narrative review presents a debate on whether surgery is a friend or a foe in the treatment of sleep apnea. Depending on the type and severity of the apnea, the causal factor, and the presence of obesity and hypercapnia as well as the associated pathologies, the optimal therapeutic method is determined for each individual case. The article concludes that each case is unique, and there is no ideal method. Positive pressure ventilation, although a therapeutic gold standard, has its disadvantages extensively discussed in this paper. Nevertheless, it is necessary prior to any surgical intervention, either for the curative treatment of the causal factor of apnea or for elective surgery for another condition. The anesthetic risks associated with the presence of apnea and obesity should not be neglected and should form the basis for decision making regarding surgical interventions for the treatment of sleep apnea. Full article

(This article belongs to the Special Issue Respiratory Health and Chronic Disease Management)

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