Submit to Special Issue Submit Abstract to Special Issue Review for JCM Propose a Special Issue

Journal Menu

Journal Browser

Advances in Pulmonary Disease Management and Innovation in Treatment

Print Special Issue Flyer
Special Issue Editors
Special Issue Information
Keywords
Benefits of Publishing in a Special Issue
Published Papers

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Respiratory Medicine".

Deadline for manuscript submissions: 15 July 2026 | Viewed by 12322

Share This Special Issue

Special Issue Editors

Dr. Monica Steluța Marc

E-Mail Website
Guest Editor

Center for Research and Innovation in Precision Medicine of Respiratory Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, Timisoara 300041, Romania
Interests: severe asthma; COPD; sleep-related breathing disorders; tabaccology; pulmonary rehabilitation; respiratory tract infections

Prof. Dr. Florin Mihaltan

E-Mail Website
Guest Editor

Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, Romania
Interests: severe asthma; COPD; sleep-related breathing disorders; tabaccology; pulmonary rehabilitation; respiratory tract infections; pulmonary vascular disease; interstitial lung disease

Special Issue Information

Dear Colleagues,

Pulmonary diseases represent a significant burden on global health systems, with increasing prevalence and complexity across diverse populations. Recent advancements in diagnostics, pharmacology, and interventional approaches have significantly improved our ability to manage conditions such as asthma, COPD, interstitial lung diseases, and sleep-related breathing disorders. This Special Issue aims to highlight personalized strategies in pulmonary disease management, from early detection and precision medicine to innovative therapeutic interventions and integrated care models. Particular attention is given to emerging technologies, biomarker-driven treatment pathways, non-invasive ventilation techniques, and smoking cessation programs. We encourage contributions that offer clinical insight and multidisciplinary relevance in the evolving field of respiratory medicine.

Dr. Monica Steluța Marc
Prof. Dr. Florin Mihaltan
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 250 words) can be sent to the Editorial Office for assessment.

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 Clinical Medicine 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

severe asthma
COPD
sleep-related breathing disorders
respiratory tract infections
innovative respiratory therapies
translational pulmonary research
pulmonary vascular disease
interstitial lung disease
eHealth in respiratory care

Benefits of Publishing in a Special Issue

Ease of navigation: Grouping papers by topic helps scholars navigate broad scope journals more efficiently.
Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
Expansion of research network: Special Issues facilitate connections among authors, fostering scientific collaborations.
External promotion: Articles in Special Issues are often promoted through the journal's social media, increasing their visibility.
Reprint: MDPI Books provides the opportunity to republish successful Special Issues in book format, both online and in print.

Further information on MDPI's Special Issue policies can be found here.

Published Papers (7 papers)

Download All Papers

Order results

Result details

Show export options Show export options

Select all

Export citation of selected articles as:

Research

Jump to: Other

15 pages, 296 KB

Open AccessArticle

Clinical Remission and Its Determinants in Adult Severe Asthma Patients Receiving Biologic Therapy: A Retrospective Analysis

by Dane Ediger, Esma Nur Aktepe Sezgin, Raziye Tülümen Öztürk and Burcu Çoban

J. Clin. Med. 2026, 15(2), 442; https://doi.org/10.3390/jcm15020442 - 6 Jan 2026

Viewed by 231

Abstract

Background/Objectives: In recent years, the concept of clinical remission under treatment in asthma has gained increasing attention. It is defined as the absence of exacerbations, asthma symptoms, and oral corticosteroid use for at least 12 months, together with improved or stable lung function. This study aimed to evaluate the clinical remission rates and associated factors in patients with severe asthma receiving biologic therapy with either omalizumab (anti-IgE) or mepolizumab (anti-IL-5). Methods: Adult patients with severe asthma and type 2 inflammation who started omalizumab or mepolizumab between January 2009 and December 2023 in our allergy clinic were retrospectively analyzed. Sociodemographic and clinical characteristics were reviewed. Clinical remission rates were assessed at the first and most recent years of maintenance therapy. Independent markers were identified using multivariable analyses. Results: A total of 160 patients were included (mean age 53.8 ± 14.6 years; 81.9% female). Of these, 85.6% received omalizumab and 14.4% mepolizumab. Remission rates at one year and at the latest follow-up were 60.0% and 43.7%, respectively. Patients achieving remission had higher total IgE levels. Psychiatric comorbidity negatively affected remission. The one-year remission rates were 91.3% in the mepolizumab group and 54.7% in the omalizumab group. Higher baseline blood eosinophil counts and Asthma Control Test (ACT) scores were positive markers, while psychiatric disease was inversely associated. Conclusions: Omalizumab and mepolizumab achieved meaningful clinical remission rates in severe asthma. Elevated ACT scores and eosinophil counts and absence of psychiatric comorbidities were independent markers, underscoring the need for individualized biologic therapy to achieve sustained remission. Full article

(This article belongs to the Special Issue Advances in Pulmonary Disease Management and Innovation in Treatment)

► Show Figures

Figure 1

17 pages, 1036 KB

Open AccessArticle

Subclinical Carotid Atherosclerosis Is Present from Early COPD Stages, Being in a Close Relationship with Systemic Inflammation

by Ioana Ciortea, Emanuela Vastag, Corneluța Fira-Mladinescu, Alexandru Florian Crisan, Norbert Wellmann, Ana Adriana Trusculescu, Nicoleta Sorina Bertici, Daniel Traila, Cristian Oancea and Ovidiu Fira-Mladinescu

J. Clin. Med. 2026, 15(1), 180; https://doi.org/10.3390/jcm15010180 - 26 Dec 2025

Viewed by 319

Abstract

Background: Several cohort studies have demonstrated a link between subclinical carotid atherosclerosis and obstructive chronic airflow limitation. These conditions exhibit common risk factors associated with unhealthy lifestyles, as well as analogous pathophysiological mechanisms, including chronic low-degree systemic inflammation. Purpose: The aim of this study was to investigate the association between airflow obstruction and carotid intima–media thickness (c-IMT), together with the influence of inflammatory biomarkers on this relationship, in patients diagnosed with chronic obstructive pulmonary disease (COPD). Methods and Patients: This study is cross-sectional and includes 106 patients with stable COPD. All patients underwent evaluation through spirometry, carotid ultrasound, and assessment of inflammatory biomarkers, including C-reactive protein, fibrinogen, and erythrocyte sedimentation rate. The relationship between carotid subclinical atherosclerosis and the Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage of COPD was assessed. Additionally, we compared patients with two positive biomarkers of inflammation with those who had no positive inflammatory biomarkers. Results: Significant statistical differences were observed in carotid intima–media thickness values associated with the severity of airflow obstruction, with measurements of 1.03 mm in COPD stage 1–2 GOLD, 1.07 mm in COPD GOLD 3, and 0.96 mm in GOLD 4 (p = 0.04). However, no direct correlation with forced expiratory volume in the first second (FEV1) was identified. The post hoc analysis revealed a notable increase in carotid wall thickness for the early stages of COPD. C-IMT demonstrated a significant association with inflammation parameters, muscle dysfunction, body composition, and lipid profile. The comparison of groups exhibiting two positive inflammatory biomarkers with those with no positive inflammatory markers revealed significant differences in age, c-IMT, exercise tolerance, and COPD symptoms. Conclusions: Subclinical carotid atherosclerosis is evident from the early stages of obstructive airflow limitation. Carotid intima–media thickness is significantly higher in patients with positive inflammatory biomarkers. Full article

(This article belongs to the Special Issue Advances in Pulmonary Disease Management and Innovation in Treatment)

► Show Figures

Figure 1

17 pages, 1782 KB

Open AccessArticle

Burden of Healthcare-Associated Infections on Mortality Among COVID-19 Hospitalized Patients

by Corina Voinea, Elena Mocanu, Elena Dantes, Sanda Jurja, Ana-Maria Neculai, Aurora Craciun and Sorin Rugina

J. Clin. Med. 2025, 14(23), 8279; https://doi.org/10.3390/jcm14238279 - 21 Nov 2025

Viewed by 469

Abstract

Background: Healthcare-associated infections (HAIs) are a significant public health problem, having a decisive impact on the prognosis of patients hospitalized with COVID-19. In Romania, the absence of a uniform reporting system and the lack of epidemiological data comparable to European standards limit the real assessment of their incidence and consequences. Methods: In this context, the present study aimed to conduct an integrated analysis of the clinical, epidemiological, and microbiological factors involved in the mortality of patients with COVID-19 and HAIs in a county located in southeastern Romania. This research was based on a retrospective observational study that included 295 patients with a confirmed diagnosis of COVID-19 and at least one documented HAI between January 2020 and December 2022. Data were extracted from standardized reporting forms, and statistical analyses included tests (Fisher’s exact test, Mann–Whitney U), ROC curves, Kaplan–Meier survival analysis, and Cox proportional hazard regression. Results: The analysis revealed a mortality rate of 32.5%, significantly associated with advanced age, gastrointestinal surgery, and respiratory infections. Clostridioides difficile was the predominant pathogen (84.1%), and the threshold of ≥63.5 years demonstrated predictive value for mortality. In multivariate models, age greater than 63 years and gastrointestinal surgery were confirmed as independent predictors of death. Conclusions: The findings highlight the substantial impact of HAIs on the clinical progression of COVID-19 patients, underscoring the need for comprehensive systemic interventions, including enhanced prevention and control strategies, prudent antimicrobial therapy, and standardized epidemiological monitoring. Implementing these measures is crucial to mitigating HAIs’ effects and improving patient outcomes in similar situations. Full article

(This article belongs to the Special Issue Advances in Pulmonary Disease Management and Innovation in Treatment)

► Show Figures

Figure 1

17 pages, 687 KB

Open AccessArticle

Prognostic Value of Routine Hematological Markers and ECOG Performance in Predicting Overall Survival in Lung Cancer—A Retrospective Cohort Study and Literature Review

by Denisa-Gabriela Ion-Andrei, Alexandra-Cristiana Gache, Elena Mocanu, Andreea-Cristina Postu, Simona-Alina Lupșă, Liliana Mocanu, Cătălina Muntean and Elena Dantes

J. Clin. Med. 2025, 14(21), 7603; https://doi.org/10.3390/jcm14217603 - 27 Oct 2025

Viewed by 826

Abstract

Background: Accurate prognostic assessment in lung cancer is challenging, especially in settings with limited access to molecular testing. Routine hematological markers may complement TNM staging in identifying high-risk patients. Methods: We retrospectively analyzed 304 patients with histologically confirmed lung cancer to evaluate the prognostic value of hematological and inflammatory markers in relation to tumor stage and ECOG performance status. Survival was estimated using Kaplan–Meier analysis and independent predictors were identified through Cox regression. Cluster analysis integrated hematological markers with tumor characteristics. Results: Most patients presented with advanced disease (61.2% T4; 57.1% metastatic). Early stages (≤IIC) were associated with nearly double the median overall survival compared with stages ≥IIIA (p = 0.001). Nodal involvement and metastases further stratified outcomes. Among hematological markers, anemia (Hb < 11.85 g/dL) and leukocytosis (WBC > 11.71 × 10⁹/L) predicted shorter survival and remained independent predictors in the multivariable Cox model (HR 1.70, p < 0.001; HR 1.54, p = 0.004), along with T4 stage (HR 1.47, p = 0.015). PLT count and fibrinogen were significant in univariate analysis but not after adjustment, while CRP and D-dimer showed no association. Cluster analysis identified two subgroups, with patients in Cluster 2 (T4 stage, anemia, leukocytosis) experiencing more than double the mortality risk compared with Cluster 1 (HR 2.33, p < 0.001). Conclusions: TNM stage remains the dominant prognostic factor in lung cancer. However, Hb and WBC count provide additional prognostic information, and cluster analysis may refine risk stratification by capturing clinically relevant heterogeneity. Full article

(This article belongs to the Special Issue Advances in Pulmonary Disease Management and Innovation in Treatment)

► Show Figures

Figure 1

24 pages, 3726 KB

Open AccessArticle

Telemedicine-Supported CPAP Therapy in Patients with Obstructive Sleep Apnea: Association with Treatment Adherence and Clinical Outcomes

by Norbert Wellmann, Versavia Maria Ancusa, Monica Steluta Marc, Ana Adriana Trusculescu, Camelia Corina Pescaru, Flavia Gabriela Martis, Ioana Ciortea, Alexandru Florian Crisan, Adelina Maritescu, Madalina Alexandra Balica and Ovidiu Fira-Mladinescu

J. Clin. Med. 2025, 14(15), 5339; https://doi.org/10.3390/jcm14155339 - 29 Jul 2025

Cited by 1 | Viewed by 2649

Abstract

Background/Objectives: Obstructive sleep apnea (OSA) is a highly prevalent disorder that significantly impacts quality of life and daily functioning. While continuous positive airway pressure (CPAP) therapy is effective, long-term adherence remains a challenge. This single-arm observational study aimed to evaluate clinical outcomes and adherence patterns during telemedicine-supported CPAP therapy and identify distinct phenotypic response clusters in Romanian patients with OSA. Methods: This prospective observational study included 86 adults diagnosed with OSA, treated with ResMed Auto CPAP devices at “Victor Babeș” University Hospital in Timișoara, Romania. All patients were remotely monitored via the AirView™ platform and received monthly telephone interventions to promote adherence when necessary. Clinical outcomes were assessed through objective telemonitoring data. K-means clustering and t-distributed stochastic neighbor embedding (t-SNE) were employed to explore phenotypic response patterns. Results: During telemedicine-supported CPAP therapy, significant clinical improvements were observed. The apnea–hypopnea index (AHI) decreased from 42.0 ± 21.1 to 1.9 ± 1.3 events/hour. CPAP adherence improved from 75.5% to 90.5% over six months. Average daily usage increased from 348.4 ± 85.8 to 384.2 ± 65.2 min. However, post hoc analysis revealed significant concerns about the validity of self-reported psychological improvements. Self-esteem changes showed negligible correlation with objective clinical measures (r < 0.2, all p > 0.1), with only 3.3% of variance being explained by measurable therapeutic factors (R² = 0.033). Clustering analysis identified four distinct adherence and outcome profiles, yet paradoxically, patients with lower adherence showed greater self-esteem improvements, contradicting therapeutic causation. Conclusions: Telemedicine-supported CPAP therapy with structured monthly interventions was associated with substantial clinical improvements, including excellent AHI reduction (22-fold) and high adherence rates (+15% after 6 months). Data-driven phenotyping successfully identified distinct patient response profiles, supporting personalized management approaches. However, the single-arm design prevents definitive attribution of improvements to telemonitoring versus natural adaptation or placebo effects. Self-reported psychological outcomes showed concerning patterns suggesting predominant placebo responses rather than therapeutic benefits. While the overall findings demonstrate the potential value of structured telemonitoring for objective CPAP outcomes, controlled trials are essential to establishing true therapeutic efficacy and distinguishing intervention effects from measurement bias. Full article

(This article belongs to the Special Issue Advances in Pulmonary Disease Management and Innovation in Treatment)

► Show Figures

Figure 1

Other

Jump to: Research

11 pages, 927 KB

Open AccessSystematic Review

Global Lessons from COVID-19: Regional Variations in the Management of Hospital-Acquired Infections During and Post-Pandemic

by Corina Voinea, Elena Mocanu, Cristian Opariuc-Dan, Elena Dantes, Alexandra-Cristina Gache and Sorin Rugina

J. Clin. Med. 2025, 14(18), 6654; https://doi.org/10.3390/jcm14186654 - 22 Sep 2025

Cited by 1 | Viewed by 783

Abstract

Background/Objectives: The COVID-19 pandemic has significantly disrupted healthcare systems worldwide, exposing longstanding weaknesses, particularly in the prevention and control of healthcare-associated infections (HAIs). Regional disparities in infection prevention and control (IPC) strategies offered valuable lessons for improving public health preparedness. This systematic review aims to identify and compare regional IPC approaches adopted during and after the pandemic, highlighting best practices to strengthen healthcare resilience. Methods: The review was conducted in line with PRISMA guidelines and registered in the PROSPERO database (CRD420251032525). Articles published between 1 January 2020 and 31 March 2025, were retrieved from PubMed, Scopus, and Web of Science. Only full-text studies in English were included. The risk of bias was assessed using the ROBINS-I tool. Results: Of the 63 articles initially identified, 8 met the inclusion criteria. The selected studies demonstrated substantial variability in the implementation of IPC. The availability of infrastructure, funding, coordination capacity, and training of medical staff had a significant impact on outcomes. In regions with well-defined protocols and a solid infrastructure, there was a significant decrease in HAIs, while in resource-poor areas, there was a significant increase. Effective measures included continuous monitoring, regular staff training, provision of adequate equipment, expansion of testing capacity, reorganisation of hospitals, and introduction of technological innovations in healthcare. Conclusions: COVID-19 emphasised the importance of adaptable IPC frameworks. Strengthening health systems requires context-specific standards, sustained investment in infrastructure, continuous training, and increased international cooperation to better prepare for future health emergencies. Full article

(This article belongs to the Special Issue Advances in Pulmonary Disease Management and Innovation in Treatment)

► Show Figures

Figure 1

41 pages, 9317 KB

Open AccessSystematic Review

High-Resolution CT Findings in Interstitial Lung Disease Associated with Connective Tissue Diseases: Differentiating Patterns for Clinical Practice—A Systematic Review with Meta-Analysis

by Janet Camelia Drimus, Robert Cristian Duma, Daniel Trăilă, Corina Delia Mogoșan, Diana Luminița Manolescu and Ovidiu Fira-Mladinescu

J. Clin. Med. 2025, 14(17), 6164; https://doi.org/10.3390/jcm14176164 - 31 Aug 2025

Cited by 1 | Viewed by 6384

Abstract

Objectives: Connective tissue diseases (CTDs) include a diverse group of systemic autoimmune conditions, among which interstitial lung disease (ILD) is acknowledged as a major determinant of prognosis. High-resolution computed tomography (HRCT) is the gold standard for ILD assessment. The distribution of HRCT patterns across CTDs remain incompletely defined. The objective of this systematic review is to synthesize available evidence regarding the prevalence of specific radiological patterns within CTD-ILDs and to assess whether specific patterns occur at different frequencies among individual CTDs. Methods: The inclusion criteria encompassed original human studies published in English between 2015 and 2024, involving adult participants (≥18 years) with CTD-ILDs assessed primarily by HRCT and designed as retrospective, prospective, or cross-sectional trials with extractable data. We systematically searched PubMed, Scopus, and Web of Science (January 2025). Risk of bias was evaluated using the Newcastle–Ottawa Scale (NOS) for cohort and case–control studies, and the JBI Critical Appraisal Checklist for cross-sectional studies. Data were extracted and categorized by HRCT pattern for each CTD, and then summarized descriptively and statistically. Results: We analyzed 23 studies published between 2015 and 2024, which included 2020 patients with CTD-ILDs. The analysis revealed non-specific interstitial pneumonia (NSIP) as the most prevalent pattern overall (36.5%), followed by definite usual interstitial pneumonia (UIP) (24.8%), organizing pneumonia (OP) (9.8%) and lymphoid interstitial pneumonia (LIP) (1.25%). HRCT distribution varied by CTD: NSIP predominated in systemic sclerosis, idiopathic inflammatory myopathies, and mixed connective tissue disease; UIP was most frequent in rheumatoid arthritis; LIP was more common in Sjögren’s syndrome. While global differences were statistically significant, pairwise comparisons often lacked significance, likely due to sample size constraints. Discussion: Limitations include varying risk of bias across study designs, heterogeneity in HRCT reporting, small sample sizes, and inconsistent follow-up, which may reduce precision and generalizability. In addition to the quantitative synthesis, this review offers a detailed description of each radiologic pattern mentioned above, illustrated by representative examples to support the recognition in clinical settings. Furthermore, it includes a brief overview of the major CTDs associated with ILD, summarizing their epidemiological data, risk factors for ILD and clinical presentation and diagnostic recommendations. Conclusions: NSIP emerged as the most common HRCT pattern across CTD-ILDs, with UIP predominating in RA. Although inter-disease differences were observed, statistical significance was limited, likely reflecting sample size constraints. These findings emphasize the diagnostic and prognostic relevance of HRCT pattern recognition and highlight the need for larger, standardized studies. Full article

(This article belongs to the Special Issue Advances in Pulmonary Disease Management and Innovation in Treatment)

► Show Figures

Journal Menu

Journal Browser

Advances in Pulmonary Disease Management and Innovation in Treatment

Share This Special Issue

Special Issue Editors

Special Issue Information

Keywords

Benefits of Publishing in a Special Issue

Published Papers (7 papers)

Research

Other

Further Information

Guidelines

MDPI Initiatives

Follow MDPI