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BackgroundSarcoidosis and hypersensitivity pneumonitis (HP) are two distinct clinical entities that share granulomatous inflammation, although each of them has specific clinical, radiologic and pathologic profiles. Coexistence of the two diseases have been described, suggesting, at least in some cases, a common biologic background.Case presentationWe describe two patients showing the concurrent diagnosis of sarcoidosis and hypersensitivity pneumonitis. Case 1: a 51-year old never smoker man had a history of occupational exposure, episodes of acute exacerbations and positive serum precipitins to Penicillium spp suggestive of HP, while the positivity of serum angiotensin converting enzyme (ACE) favored sarcoidosis. Case 2: a 42-year old non-smoker woman with occasional finding of enlarged mediastinal lymph nodes had a history of domestic exposure to molds and positive serum precipitins to Aspergillus spp suggestive of HP.In both cases high resolution computed tomography (HRCT) together with broncoscopy findings allowed to maintain both the diagnoses: HRCT showed both enlarged hilar/mediastinal limph nodes and intersitial lung involvement typical of HP; bronchoalveolar lavage presented marked lymphocytosis and granulomatous nodal lesions were observed at transbronchial needle aspiration.Case presentationWe describe two patients showing the concurrent diagnosis of sarcoidosis and hypersensitivity pneumonitis. Case 1: a 51-year old never smoker man had a history of occupational exposure, episodes of acute exacerbations and positive serum precipitins to Penicillium spp suggestive of HP, while the positivity of serum angiotensin converting enzyme (ACE) favored sarcoidosis. Case 2: a 42-year old non-smoker woman with occasional finding of enlarged mediastinal lymph nodes had a history of domestic exposure to molds and positive serum precipitins to Aspergillus spp suggestive of HP.In both cases high resolution computed tomography (HRCT) together with broncoscopy findings all

Idiopathic pulmonary fibrosis (IPF), the most lethal form of interstitial pneumonia of unknown cause, is associated with a specific radiological and histopathological pattern (the so‐called “usual interstitial pneumonia” pattern) and has a median survival estimated to be between 3 and 5 years after diagnosis. However, evidence shows that IPF has different clinical phenotypes, which are characterized by a variable disease course over time. At present, the natural history of IPF is unpredictable for individual patients, although some genetic factors and circulating biomarkers have been associated with different prognoses. Since in its early stages, IPF may be asymptomatic, leading to a delayed diagnosis. Two drugs, pirfenidone and nintedanib, have been shown to modify the disease course by slowing down the decline in lung function. It is also known that 5–10% of the IPF patients may be affected by episodes of acute and often fatal decline. The acute worsening of disease is sometimes attributed to identifiable conditions, such as pneumonia or heart failure; but many of these events occur without an identifiable cause. These idiopathic acute worsenings are termed acute exacerbations of IPF. To date, clinical biomarkers, diagnostic, prognostic, and theranostic, are not well characterized. However, they could become useful tools helping facilitate diagnoses, monitoring disease progression and treatment efficacy. The aim of this review is to cover molecular mechanisms underlying IPF and research into new clinical biomarkers, to be utilized in diagnosis and prognosis, even in patients treated with antifibrotic drugs.

Porcine circovirus type 3 (PCV-3) infection is widely distributed in domestic pig populations in America, Europe, and Asia. However, no data is currently available about its presence and distribution in Africa. This study investigated the presence of PCV-3 in pigs (n = 122) in Namibia, by means of biomolecular methods. The pig samples collected (n = 122) were representative of the swine industry in Namibia, covering the major pig production facilities in the country. All of the samples tested were negative for PCV-3, and this indicated that the virus was either not present in the country or was circulating at low levels. Further studies are needed to better understand the distribution, if any, of PCV-3 in Namibia.

Porcine circovirus type 3 (PCV-3) infection is widely distributed in domestic pig populations in America, Europe, and Asia. However, no data is currently available about its presence and distribution in Africa. This study investigated the presence of PCV-3 in pigs (n = 122) in Namibia, by means of biomolecular methods. The pig samples collected (n = 122) were representative of the swine industry in Namibia, covering the major pig production facilities in the country. All of the samples tested were negative for PCV-3, and this indicated that the virus was either not present in the country or was circulating at low levels. Further studies are needed to better understand the distribution, if any, of PCV-3 in Namibia.

Porcine circovirus type 3 (PCV-3) infection is widely distributed in domestic pig populations in America, Europe, and Asia. However, no data is currently available about its presence and distribution in Africa. This study investigated the presence of PCV-3 in pigs (n = 122) in Namibia, by means of biomolecular methods. The pig samples collected (n = 122) were representative of the swine industry in Namibia, covering the major pig production facilities in the country. All of the samples tested were negative for PCV-3, and this indicated that the virus was either not present in the country or was circulating at low levels. Further studies are needed to better understand the distribution, if any, of PCV-3 in Namibia.

Porcine circovirus type 3 (PCV-3) infection is widely distributed in domestic pig populations in America, Europe, and Asia. However, no data is currently available about its presence and distribution in Africa. This study investigated the presence of PCV-3 in pigs (n = 122) in Namibia, by means of biomolecular methods. The pig samples collected (n = 122) were representative of the swine industry in Namibia, covering the major pig production facilities in the country. All of the samples tested were negative for PCV-3, and this indicated that the virus was either not present in the country or was circulating at low levels. Further studies are needed to better understand the distribution, if any, of PCV-3 in Namibia.

Porcine circovirus type 3 (PCV-3) infection is widely distributed in domestic pig populations in America, Europe, and Asia. However, no data is currently available about its presence and distribution in Africa. This study investigated the presence of PCV-3 in pigs (n = 122) in Namibia, by means of biomolecular methods. The pig samples collected (n = 122) were representative of the swine industry in Namibia, covering the major pig production facilities in the country. All of the samples tested were negative for PCV-3, and this indicated that the virus was either not present in the country or was circulating at low levels. Further studies are needed to better understand the distribution, if any, of PCV-3 in Namibia.

Lung volume reduction (LVR) procedures for emphysematous patients were firstly introduced in the second half of the twentieth century. Over time, from the first invasive surgical procedures, new less invasive techniques have been conceived. In regards to the surgical approach, the adoption of VATS and the execution, in selected centers, of a non-resectional approach, with folding of less functional lung tissue, reduced mortality and adverse events risks. As regards to the bronchoscopic approach, endobronchial valves (EBV) and intrabronchial valves (IBV) were initially proposed in the early 2000s to obtain segmental or lobar atelectasis of the more compromised lung parenchyma. Despite showing promising results with respect to improvement of pulmonary function tests, particularly forced expiratory volume in 1st second (FEV1), and quality of life, and a good safety profile, valves showed disappointing results in presence of collateral ventilation, such as in cases of incomplete fissures. To overcome this technical issue, in the last 10 years, endobronchial coils have been designed and used. Having a compressive effect on the lung parenchyma where they are located, they are not affected by collateral ventilation. Randomized control trials (RCTs) on endobronchial coils showed a significant improvement in FEV1 and quality of life, however this technique was not immune to side effects, particularly low respiratory tract infections and pneumothoraces. Besides bronchial valves (BV) and coils, airway by-pass stents have also been evaluated in a RCT but without reaching the desired endpoints. Other innovative procedures recently considered and delivered through bronchoscopy regards thermal energy, with vapour therapy, to achieve a scarring reaction of the emphysematous lung parenchyma, and polymeric foams used as lung sealants to achieve absorptive atelectasis. In conclusion, LVR procedures may be considered in carefully selected patients with symptomatic emphysema and severe

In January 2019, high mortalities were reported among African Penguins (Spheniscus demersus) in a breeding colony on Halifax Island, Namibia, Africa. Analysis of samples by reverse transcription quantitative PCR indicated the presence of highly pathogenic avian influenza (HPAI) subtype H5N8. Sequence analysis of the hemagglutinin and neuraminidase genes confirmed the presence of the virus in the birds and its high similarity to HPAI subtype H5N8 identified in South Africa in 2017. There have been no previous reports of HPAI H5N8 in Namibia.

In January 2019, high mortalities were reported among African Penguins (Spheniscus demersus) in a breeding colony on Halifax Island, Namibia, Africa. Analysis of samples by reverse transcription quantitative PCR indicated the presence of highly pathogenic avian influenza (HPAI) subtype H5N8. Sequence analysis of the hemagglutinin and neuraminidase genes confirmed the presence of the virus in the birds and its high similarity to HPAI subtype H5N8 identified in South Africa in 2017. There have been no previous reports of HPAI H5N8 in Namibia.

In January 2019, high mortalities were reported among African Penguins (Spheniscus demersus) in a breeding colony on Halifax Island, Namibia, Africa. Analysis of samples by reverse transcription quantitative PCR indicated the presence of highly pathogenic avian influenza (HPAI) subtype H5N8. Sequence analysis of the hemagglutinin and neuraminidase genes confirmed the presence of the virus in the birds and its high similarity to HPAI subtype H5N8 identified in South Africa in 2017. There have been no previous reports of HPAI H5N8 in Namibia.

In January 2019, high mortalities were reported among African Penguins (Spheniscus demersus) in a breeding colony on Halifax Island, Namibia, Africa. Analysis of samples by reverse transcription quantitative PCR indicated the presence of highly pathogenic avian influenza (HPAI) subtype H5N8. Sequence analysis of the hemagglutinin and neuraminidase genes confirmed the presence of the virus in the birds and its high similarity to HPAI subtype H5N8 identified in South Africa in 2017. There have been no previous reports of HPAI H5N8 in Namibia.

Chronic airway infection is a key aspect of the pathogenesis of bronchiectasis. A growing interest has been raised on non-tuberculous mycobacteria (NTM) infection. We aimed at describing the clinical characteristics, diagnostic process, therapeutic options and outcomes of bronchiectasis patients with pulmonary NTM (pNTM) disease. This was a prospective, observational study enrolling 261 adult bronchiectasis patients during the stable state at the San Gerardo Hospital, Monza, Italy, from 2012 to 2015. Three groups were identified: pNTM disease; chronic P. aeruginosa infection; chronic infection due to bacteria other than P. aeruginosa. NTM were isolated in 32 (12%) patients, and among them, a diagnosis of pNTM disease was reached in 23 cases. When compared to chronic P. aeruginosa infection, patients with pNTM were more likely to have cylindrical bronchiectasis and a “tree-in-bud” pattern, a history of weight loss, a lower disease severity and a lower number of pulmonary exacerbations. Among pNTM patients who started treatment, 68% showed a radiological improvement, and 37% achieved culture conversion without recurrence, while 21% showed NTM isolation recurrence. NTM isolation seems to be a frequent event in bronchiectasis patients, and few parameters might help to suspect NTM infection. Treatment indications and monitoring still remain an important area for future research.

Arboviruses cause acute diseases that increasingly affect global health. We used bluetongue virus (BTV) and its natural sheep host to reveal a previously uncharacterized mechanism used by an arbovirus to manipulate host immunity. Our study shows that BTV, similarly to other antigens delivered through the skin, is transported rapidly via the lymph to the peripheral lymph nodes. Here, BTV infects and disrupts follicular dendritic cells, hindering B-cell division in germinal centers, which results in a delayed production of high affinity and virus neutralizing antibodies. Moreover, the humoral immune response to a second antigen is also hampered in BTV-infected animals. Thus, an arbovirus can evade the host antiviral response by inducing an acute immunosuppression. Although transient, this immunosuppression occurs at the critical early stages of infection when a delayed host humoral immune response likely affects virus systemic dissemination and the clinical outcome of disease.

Chronic airway infection is a key aspect of the pathogenesis of bronchiectasis. A growing interest has been raised on non-tuberculous mycobacteria (NTM) infection. We aimed at describing the clinical characteristics, diagnostic process, therapeutic options and outcomes of bronchiectasis patients with pulmonary NTM (pNTM) disease. This was a prospective, observational study enrolling 261 adult bronchiectasis patients during the stable state at the San Gerardo Hospital, Monza, Italy, from 2012 to 2015. Three groups were identified: pNTM disease; chronic P. aeruginosa infection; chronic infection due to bacteria other than P. aeruginosa. NTM were isolated in 32 (12%) patients, and among them, a diagnosis of pNTM disease was reached in 23 cases. When compared to chronic P. aeruginosa infection, patients with pNTM were more likely to have cylindrical bronchiectasis and a “tree-in-bud” pattern, a history of weight loss, a lower disease severity and a lower number of pulmonary exacerbations. Among pNTM patients who started treatment, 68% showed a radiological improvement, and 37% achieved culture conversion without recurrence, while 21% showed NTM isolation recurrence. NTM isolation seems to be a frequent event in bronchiectasis patients, and few parameters might help to suspect NTM infection. Treatment indications and monitoring still remain an important area for future research.

During the past decades, a growing interest has been raised in evaluating nontuberculous mycobacteria (NTM) in patients with noncystic fibrosis bronchiectasis (NCFBE). This paper reviews several aspects of the correlations between NTM and NCFBE, including pathogenesis, radiological features, diagnosis, and management. Bronchiectasis and NTM lung disease are connected, but which one comes first is still an unresolved question. The rate of NTM lung disease in NCFBE varies through the studies, from 5% to 30%. The most frequent species isolated is MAC. NCFBE patients affected by NTM infection frequently present coinfections, including both other different NTM species and microorganisms, such as P. aeruginosa. Once a diagnosis of NTM disease has been reached, the initiation of therapy is not always mandatory. NTM species isolated, patients' conditions, and disease severity and its evolution should be considered. Risk factors for disease progression in NCFBE patients with NTM are low body mass index, cavitary disease, consolidations, and macrolide resistance at presentation.

During the past decades, a growing interest has been raised in evaluating nontuberculous mycobacteria (NTM) in patients with noncystic fibrosis bronchiectasis (NCFBE). This paper reviews several aspects of the correlations between NTM and NCFBE, including pathogenesis, radiological features, diagnosis, and management. Bronchiectasis and NTM lung disease are connected, but which one comes first is still an unresolved question. The rate of NTM lung disease in NCFBE varies through the studies, from 5% to 30%. The most frequent species isolated is MAC. NCFBE patients affected by NTM infection frequently present coinfections, including both other different NTM species and microorganisms, such as P. aeruginosa. Once a diagnosis of NTM disease has been reached, the initiation of therapy is not always mandatory. NTM species isolated, patients' conditions, and disease severity and its evolution should be considered. Risk factors for disease progression in NCFBE patients with NTM are low body mass index, cavitary disease, consolidations, and macrolide resistance at presentation.