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Advances in Pulmonary Disease Management and Innovation in Treatment
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Advances in Pulmonary Disease Management and Innovation in Treatment

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 January 2026 | Viewed by 779

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 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 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

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

Published Papers (2 papers)

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24 pages, 3726 KB  
Article
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
Viewed by 560
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 [...] Read more.
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)
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41 pages, 9317 KB  
Systematic 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 (registering DOI) - 31 Aug 2025
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 [...] Read more.
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)
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