Introduction: Self-monitoring has a recognized place in achieving asthma control. Traditionally, patients record symptoms and peak flow measurement in a paper diary, which they use to adjust therapy in accordance with written asthma plans. Telemonitoring augments disease management by...

Chronic obstructive pulmonary disease (COPD) is a major contributor to global respiratory morbidity and exhibits substantial sex- and gender-related differences in incidence, phenotype, pathophysiology, and outcomes across the life course. Historically regarded as a predominantly male disease due to higher smoking rates, COPD is now increasingly recognized among women, reflecting changing exposure patterns and enhanced diagnostic attention. Moreover, evidence indicates that women may be more biologically susceptible to the harmful effects of tobacco smoke and often develop COPD at younger ages. Clinical manifestations also differ, with women more frequently reporting dyspnea, anxiety, and depression, whereas men may exhibit more cough and sputum production. Imaging studies suggest that airway-predominant disease is more common in women, while men are more likely to demonstrate emphysema-predominant patterns. Furthermore, women face an increased risk of exacerbation, yet they are more likely to experience underdiagnosis or misdiagnosis. Treatment responses and comorbidity patterns also show sex- and gender-related variations. Despite these differences, most clinical guidelines and therapeutic strategies do not differentiate by sex and gender, highlighting a gap in personalized COPD management. Overall, growing evidence underscores the importance of incorporating sex and gender as biological and sociocultural variables in COPD research, diagnosis, and treatment. Recognizing sex/gender-specific risk profiles, symptom patterns, and disease phenotypes may improve early detection and enable more targeted, effective interventions. This narrative synthesis, derived from a meticulous search in PubMed and the critical selection of 74 articles from the 448 identified originally, integrates evidence from guideline statements, registry studies, mechanistic and preclinical research, imaging and physiology investigations, systematic reviews, and randomized controlled trials that report sex- and gender-disaggregated data.

Introduction: Hemoptysis is a common clinical problem in emergency departments with a broad differential diagnosis that includes life-threatening causes, hence the patient should be thoroughly assessed. Aim: The aim of this study was to evaluate the epidemiological profile of patients admitted for hemoptysis in a Respiratory medicine department and assess the role of imaging modalities in the diagnostic approach. Methods: We analyzed the medical records of 161 patients admitted with hemoptysis in the Respiratory medicine department of the University Hospital of Ioannina, between July 2020 - December 2022. Results: The mean age was 68±19.2 years, the majority (79%) were men and 80% had a smoking history. Infections and malignancy were the most frequent causes of hemoptysis (24%), followed by drug-related hemoptysis (21%) and bronchiectasis (13%). Pulmonary embolism and tuberculosis were identified in 6% and 3% of the cases, while definite diagnosis was not established in 11% of the cases. In terms of imaging, abnormal findings were reported in 60% and 86% of Xrays and CT scans, respectively. The main findings were indicative of infection or carcinoma (mass, lymphadenopathy). Massive hemoptysis was present in 5% of the cases and was attributed either to carcinoma or infection with the concurrent use of anticoagulants. Conclusions: Infections and carcinoma were the primary causes of hemoptysis in our analysis, which is in accordance with the literature. Drug-related hemoptysis, seems to be an emerging cause of hemoptysis, which could be attributed to the increasing use of anticoagulants (40% in our dataset). The diagnostic yield of CT scan was verified, while we are assessing the contribution of bronchoscopy.

Background: The behavior of fractional exhaled nitric oxide (FeNO) during treated COPD exacerbations and its agreement with blood eosinophil counts are poorly characterized. Objectives: To describe serial FeNO trajectories across hospitalized COPD exacerbations (AECOPDs), assess concordance between FeNO and blood eosinophils, and test whether these can predict length of stay (LOS). Methods: Prospective cohort of patients hospitalized for AECOPD. FeNO was measured on admission, on day 2 and at discharge; blood eosinophils and post-bronchodilator spirometry on admission and before discharge; and arterial blood gases on admission and on day 2. The admission measurements preceded the first dose of corticosteroid. All patients received guideline-directed treatment, including systemic corticosteroids. Results: Most patients were male (94.7%), with a mean age of 71.7 ± 8.3 years. FeNO fell from 16 (IQR 10–25) ppb on admission to 13.5 (7–20) ppb on day 2 and 9 (6–18) ppb at discharge (p < 0.001). Blood eosinophils fell from 60 (20–150) to 0 (0–40) cells/µL (p < 0.001), and FEV1 increased from 38% to 45% predicted (p < 0.001). Agreement between biomarkers on admission was poor (ρ = 0.21, p = 0.07; κ = 0.08, 95% CI −0.15 to +0.30), and 31 patients (40.8%) were classified differently by the two markers. Admission FeNO (ρ = 0.03, p = 0.79), ΔFeNO (ρ = −0.12, p = 0.31), and admission eosinophils (ρ = −0.08, p = 0.49) were not associated with LOS. Of the patients who were type-2-high on admission (FeNO ≥ 20 ppb), 57% had fallen below that threshold by day 2 and 62% by discharge (71% and 71%, respectively, at ≥25 ppb). Over the admission-to-discharge interval, the changes in the two markers were unrelated once each was adjusted for its own admission value (partial ρ = 0.05, p = 0.73), and there was no agreement on the direction of change (κ = 0.03). Conclusions: FeNO progressively declines during treated AECOPD, alongside a fall in the blood eosinophil count, so that the type-2 label assigned on admission is no longer valid for most patients 48 h later. FeNO and blood eosinophils identified largely non-overlapping patients, and no biomarker predicted length of stay.