Background: Obstructive sleep apnea (OSA) is a common disorder associated with major cardiovascular and neurocognitive sequelae. Continuous positive airway pressure (CPAP) is the standard treatment for OSA. The aim of this study was to investigate the prevalence and associations of long-term CPAP adherence in newly diagnosed OSA patients. Methods: We enrolled patients who were diagnosed with OSA during the COVID-19 pandemic. Adherence was defined as CPAP use ≥4 h per night on ≥70% of nights over 30 consecutive days. Patient demographics were retrieved from medical records, and CPAP adherence at 6 months and 1 year after initiation was monitored. Results: Overall, 107 patients were included in the analysis. A number of 73 (68%) and 63 (59%) patients were adherent to CPAP treatment at 6 months and 12 months accordingly. Among the factors examined and analyzed (age, gender, BMI, Apnea–Hypopnea Index (AHI)), no significant correlation was found. Further analysis revealed the potential role of comorbidities. CPAP compliance at 6 months was shown to be associated with better CPAP adherence at 12 months. Conclusions: CPAP adherence at 6 months is correlated to long-term adherence to treatment. Therefore, early close follow-up is important. Further prospective studies are needed to identify other potential predictors.

Background: Real-world data on currently used biologic agents in patients with severe asthma are lacking. Methods: In this retrospective study, we recorded between 16 May 2020 and 31 December 2024 consecutive patients who presented to our asthma outpatient clinic received a diagnosis of uncontrolled severe asthma and were treated with biologic agents. Outcomes included a comparison of disease phenotypic characteristics, as well as asthma control, lung function, longitudinal use of corticosteroids, and hospitalizations due to exacerbations at baseline and post-biologic treatment at 6-month follow-up. Results: We identified 80 patients with uncontrolled severe asthma treated with biologic agents. The median age (95% CI) at the time of diagnosis was 67.0 (61.0 to 70.0) years. Most patients were female (65.0%, n = 52) and never smokers (51.3%, n = 41). The median value of ACT (95% CI) was 15 (15 to 16) at the time of diagnosis. The mean FEV₁% predicted ±SD at the baseline was 68.9 ± 22.0. The median value of blood eosinophils (95% CI) was 365 (252 to 448) K/μL in the overall population. One-third (36.3%) of patients were hospitalized due to severe asthma exacerbation in the previous year. Longitudinal use of oral corticosteroids was recorded in 11.3% of included patients. Three patients (3.8%) were treated with omalizumab, 23 patients (28.8%) with mepolizumab, 33 patients (41.2%) with benralizumab and 21 patients (26.2%) with tezepelumab. The median value of ACT (95% CI) post-biologic treatment at 6-month follow-up was 20 (20 to 21), p < 0.0001. The mean FEV₁% predicted ±SD at 6-month follow-up was 77.6 ± 25.2, p = 0.12. The median value of blood eosinophils (95% CI) 6 months after initiation of biologic treatment was 100 (40 to 121) K/μL, p < 0.0001. Elimination of hospitalizations due to asthma flares was recorded in 97.5% of patients (p < 0.0001). With regard to the longitudinal use of oral corticosteroids, we noticed that 96.2% of patients achieved discontinuation. No treatment-related adverse events were noticed. Conclusions: The administration of current biologic agents in patients with severe asthma seems to be both effective and safe, sparing the toxicity of oral corticosteroids.

Background: Accurate and timely molecular testing in patients with non-small cell lung cancer (NSCLC) is mandatory for targeted therapies and improved outcomes. Real-world obstacles, including geographic distance from specialized lung cancer services, along with comorbidities, may delay molecular diagnosis and subsequent treatment, therefore hampering survival. Methods: We conducted a retrospective, multi-departmental observational study of 927 patients with newly diagnosed NSCLC that were referred to a tertiary hospital in western Greece between January 2021 and December 2024. Patients were classified based on distance of residence (<30 km vs. ≥30 km). Clinical characteristics, time elapsed from pathological to final molecular diagnosis, and survival outcomes were analyzed and compared. Multivariable Cox regression was used to identify independent predictors of overall survival. Results: Patients residing ≥30 km away (61.2%) experienced delays in molecular testing (median 31 vs. 26 days, p = 0.002) and were less likely to undergo such testing (p = 0.012) compared to those residing 30 km also had a higher prevalence of COPD (42.5% vs. 31.2%, p = 0.002). Median survival from initial pathological diagnosis to death was significantly shorter in non-urban patients (129 vs. 215 days, p = 0.010). A molecular testing delay >35 days was independently associated with worse survival (HR = 0.684, 95% CI: 0.508–0.923, p = 0.013). No differences in TNM stage distribution were observed between geographical groups. Conclusions: Geographic disparities significantly impact access to advanced lung cancer services and molecular diagnostics and may provisionally affect prognosis in NSCLC. Improving testing pathways, incorporating reflex testing in pathological molecular analysis, and optimizing referral systems in rural areas may help to reduce inequalities and improve patient outcomes.

Background and Objectives: Despite the devastating impact of acute exacerbations of fibrotic interstitial lung diseases (AE-fILDs), established treatment strategies are majorly lacking. The therapeutic potential of intravenous immunoglobulin (IVIG) in AE-fILDs was explored considering its anti-inflammatory and immunomodulatory effects, as well as the immunocompromised status of fILD patients and the high frequency of infections that AE-fILDs triggers. Materials and Methods: This was an observational, retrospective study. We investigated the therapeutic potential of IVIG in patients hospitalized for AE-fILDs between May 2021 and November 2024. Results: We included 39 patients diagnosed with AE-fILDs. All patients received IVIG (total dose of 1 g/kg, divided into three daily doses), pulse corticosteroids for three days and broad-spectrum antibiotics. No adverse events were considered to be related to IVIG therapy during the study period. The in-hospital and the 90-day mortality were 10 (26%) and 13 (33%) patients, respectively. Twenty-nine patients (74%) were discharged and 18 of them (62%) were in need of long-term oxygen therapy. The mean PaO₂/FiO₂ ratio (P/F ratio) was 183 mmHg on admission and 294 mmHg on discharge (t-test, p < 0.0001). Conclusions: This study suggests a potential therapeutic signal, indicating that IVIG is a relatively harmless, well-tolerated, and a potentially effective add-on treatment to current therapeutic approaches. Further research is essential to clarify the role of IVIG, determine optimal treatment protocols, and assess its efficacy in different ILD subtypes.

Background: The novel SARS-CoV-2 pandemic has inflicted a major blow on public health worldwide accounting for millions of deaths and subsequent socio-economic consequences. The main challenge for scientists and researchers has been to restrain transmission of the virus and prevent severe respiratory disease. Novel promising vaccines aim to fulfil these expectations, although new variants of the coronavirus have emerged. The present manuscript aims to add to the knowledge, through a case of an immunodeficient patient, who developed remarkably favorable recovery from SARS-CoV-2 pneumonia after having been fully vaccinated against the novel coronavirus. Case presentation: An 82-year-old Caucasian male with a history of metastatic pancreatic cancer was admitted with signs and symptoms of pneumonia. Workup revealed a positive SARS-CoV-2 real time – polymerase chain reaction (RT-PCR) and further investigation identified a B.1.1.7 variant. The imaging essays showed extensive lung disease. Interestingly, the patient had already received the second dose of the BNT162b2 (Pfizer) vaccine against the new coronavirus 16 days prior. After having been treated with appropriate antiviral and antibiotical agents the patient showed significantly favorable recovery and no need for high oxygen flows and no complications presented. The patient was discharged after six days of hospitalization in good condition, with no need for supplementary oxygen at home. Conclusions: Despite breakthrough cases, vaccination against COVID-19 is crucial for restraining the novel coronavirus. Further studies should be carried out in order to determine the optimal strategies for large-scale vaccination while minimizing the risk of further and faster evolution of the virus.

Background: Hypereosinophilic syndrome (HES) is a heterogeneous group of rare disorders defined by the presence of marked eosinophilia resulting in end organ damage. The diagnostic approach is multidisciplinary and treatment goals include reductions in flares and eosinophils with minimal drug-related side effects. Results: Eleven patients (n = 11) with a diagnosis of idiopathic HES were included in the study [M/F: 6/5, median age: 54 (95% CI: 38.2 to 68.5), smokers/never smokers: 5/6]. Asthma was present in the majority of them (n = 8, 72.7%); four patients (n = 4, 36.4%) presented with eosinophilic pleural effusions, two patients (n = 2, 18.2%) with cardiac arrhythmias, and one with bilateral eyelid angioedema. Eight patients (72.7%) were treated with mepolizumab (300 mg/month) and three (27.3%) with benralizumab (30 mg/4 weeks). The median values of eosinophils at baseline and 12 months after initiation of biologic agent were 3000 (95% CI: 2172 to 11,365) K/μL and 50 (95% CI: 3 to 190) K/μL, respectively, p = 0.0002. All patients with concomitant asthma (n = 8) experienced elimination of asthma flares, asthma control (ACQ < 0.75), functional improvement (mean ΔFEV1: 857 ± 594 mL), and an 82% reduction in oral corticosteroids, p = 0.0001. Materials and Methods: Patients with highly characterized idiopathic HES treated with anti-eosinophilic agents between 1 October 2019 and 1 October 2023 were retrospectively included in the study. The aim of this study was to present clinical, laboratory, and functional features and outcomes in patients with thoroughly investigated idiopathic HES treated with biologic agents targeting eosinophils. Conclusions: Biologic agents in patients with idiopathic HES—following thorough diagnostic investigation—are both safe and effective, sparing the toxicity of immunosuppressive agents. Real-life data from larger registries are greatly anticipated.