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Simple Summary: Cancer is implicated in multiple pathways that increase thrombogenicity, and lung cancer patients have a 20% higher risk of venous thromboembolism in comparison to the general population. Venous thromboembolic disease (VTE) in cancer patients, which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), can lead to the delay of cancer treatment and, thus, result in increased mortality, morbidity, and burden on healthcare resources. Factors contributing to thrombotic burden are related to cancer, patients, treatment, and laboratory findings. Thromboprophylaxis during active lung cancer treatment with adequate anticoagulation might improve outcomes. Thromboprophylaxis with low molecular weight heparin (LMWH) is the standard of care, but due to the vast heterogeneity of lung cancer patients, there is no consensus on the optimal dose and duration of the treatment. Background: The aim of this study was to record and assess the efficacy and safety ofthromboprophylaxis with an intermediate dose of Tinzaparin in lung cancer patients with high thrombotic risk. Methods: This was a non-interventional, single-arm, prospective cohort study of lung cancer patients who received thromboprophylaxis with Tinzaparin 10.000 Anti-Xa IU in 0.5 mL, OD, used in current clinical practice. Enrolled ambulatory patients signed informed consent. Anti-Xa levels were tested. Results: In total, 140 patients were included in the study, of which 81.4% were males. The histology of the tumor was mainly adenocarcinoma. Lung cancer patients with high thrombotic risk based on tumor, patient, treatment, and laboratory-related factors were enrolled. Only one patient experienced a thrombotic event (0.7%), and 10 patients had bleeding events (7.1%), including only one major event. Anti-Xa levels measured at 10 days and 3 months did not differ significantly between patients who developed hemorrhagic events and those who did not (p = 0.26 and p = 0.32, respectively). Conclusion: Thromboprophylaxis with an intermediate Tinzaparin dose in high thrombotic-risk lung cancer patients is a safe and effective choice for the prevention of VTE. [ABSTRACT FROM AUTHOR]

INTRODUCTION: There is a current lack of epidemiological data regarding lung cancer in Greece. The aim of this study was to record and analyze pertinent data regarding demographic, clinical, radiological, bronchoscopic and histological findings in lung cancer cases over a ten-year period collected from a hospital in Central Greece, and to investigate potential specific features of lung cancer in Greek patients. METHODS: This was a retrospective cohort study. The data collected were obtained from newly diagnosed lung cancer patients with fiberoptic bronchoscopy during a ten-year period (2009-2018). From the database, we have extracted the demographic data, the tumor location based on the computed tomography (CT) scans, bronchoscopy report with associated images and the histopathology/cytology reports that yielded the diagnosis. RESULTS: A total number of 637 patients were diagnosed with primary lung cancer during the decade 2009-2018 from the authors in a major tertiary hospital in Athens, Greece. Most of the patients were aged 50-69 years (57.6%) and the majority were men (77.1%) and active smokers (74.1%). The most common histological type was adenocarcinoma (31.7%). In the majority of cases, the patients presented initially at advanced stages. At the time of diagnosis, the most common finding was a lung mass or nodule in computed tomography and an endobronchial mass in fiberoptic bronchoscopy. The patients' lesions were detected most frequently in the upper lobes. CONCLUSIONS: The results show a trend in ADLC histology, an increase in the proportion of women with lung cancer and highlight the significant percentage of patients diagnosed in advanced stages. This reflects the need for effective tobacco control strategies to reduce the incidence of lung cancer and a comprehensive national screening program for the purposes of early detection. [ABSTRACT FROM AUTHOR]

Chronic respiratory diseases comprise of chronic obstructive pulmonary disease (COPD), asthma, occupational lung diseases and bronchiectasis, amongst others. Most of these long-term diseases are not curable and cause an enormous economic burden. Mucoregulators such as ambroxol have been used for decades as a treatment for pulmonary diseases, in order to reduce the burden of the disease and improve quality of life by promoting mucus clearance. Effects of ambroxol include the increase of surfactant production, cytokine reduction and counteracting of oxidative stress in the lungs. Positive effects of ambroxol have been described in vitro and in clinical studies for COPD, chronic bronchitis as well as in acute respiratory infections. In addition, antiviral, antibacterial and antifungal properties have been demonstrated. Αmbroxol has a good safety profile. In this short review article, the current clinical knowledge on Ambroxol is summarized. [ABSTRACT FROM AUTHOR]

Objective To assess the thyroid function in patients with acute pulmonary embolism, in order to evaluate the prognostic value of thyroid hormones. Methods We studied 31 consecutive patients with acute pulmonary embolism. Measured variables upon admission included the ratio of the partial pressure of oxygen in arterial blood to the inspired oxygen fraction (PaO 2 /FiO 2 ), acute physiology and chronic health evaluation II score, risk stratification indices and plasma levels of triiodothyronine, free thyroxine, and thyroid stimulating hormone. Results Plasma levels of triiodothyronine were below normal level in 7 patients (22.6%). Plasma triiodothyronine correlated with PaO 2 /FiO 2 ( P < 0.05) and with acute physiology and chronic health evaluation II score ( P < 0.01). In four patients (12.9%) who died, triiodothyronine levels were significantly lower ( P < 0.01) than that in patients who survived. In contrast both groups had similar levels of free thyroxine, and thyroid stimulating hormone. Moreover, triiodothyronine levels negatively correlated with serum markers of right ventricular dysfunction. Accordingly, in multivariate logistic regression analysis, the only factors independently associated with an increased risk of death were triiodothyronine and PaO 2 /FiO 2 . Conclusions Our preliminary data suggest that low plasma triiodothyronine is an independent predictor of in-hospital death in patients with acute pulmonary embolism. [ABSTRACT FROM AUTHOR]

Worldwide, approximately half of the patients diagnosed with lung cancer (LC) will develop, simultaneously or asynchronously, brain metastases (BMs). The existence of BMs negatively affects the quality of life and constitutes a poor prognostic factor, linked with high mortality. Locoregional therapy with surgery or radiation is, until now, the treatment of choice, especially for symptomatic patients; however, both options are linked to a high complication rate. The question arising here is whether, in asymptomatic patients, the benefit outweighs the risk and whether an alternative method can be used to treat this special category of patients. Over the last decade, immune checkpoint inhibitors (ICIs) have represented a major breakthrough in the field of oncology, and several molecules have been approved as a treatment option for LC. This review tried to analyze the tumor microenvironment of both the primary lung tumor and the BMs in order to evaluate the intracranial activity of ICIs, outline the main challenges of including these agents in the treatment of LC with BMs, highlight the available information from the main clinical trials, and mark the potential positive effect of choosing a combination therapy. In conclusion, it appears that immunotherapy has a positive effect, inhibiting the progression of BMs, but more data should be published specifically for this category of patients.