It was June 2015 when a group of doctors from the Spedali Civili of Brescia, Italy, created the
rst social network dedicated to the study of pleural diseases, called Pleural-HUB. 

In a short time, it has become a virtual place to share curiosities about the pleura, discuss the mecha-nisms of the pathologies that aect it, and compare the possible methods for diagnosis and treatment.

Today the group has over 5000 members from all over the world.

ey include professors,
researchers, clinicians, young doctors in training, nurses, and physiotherapists, all willing to get involved and share their experiences and uncertainties. e progressive growth of the group and its activities represent the expression of a widespread desire for knowledge in a eld of medicine that has been underappreciated for a long time.

Pleural diseases often occupy a small part of books on respiratory disorders, even though pleural diseases are commonly found in medical practice, especially by pulmonologists, internists, oncologists, radiologists, and thoracic surgeons.
e Pleural-HUB group has become a tool through which many clinicians ask for help in
dealing with complicated cases, quickly obtaining an exchange of views among dozens of doctors from dierent teams and dierent hospital contexts.

In addition to its immediate clinical use, this approach is extremely didactic and has led us to
the idea of collecting some cases and presenting them together with the discussions that doctors
carried out in the real world.

e project, initially called Pleural disease in real-life was quite ambitious. anks to the
extensive network of collaborations, the work was pleasant and rewarding on many occasions.
e COVID-19 pandemic hindered the writing of the book as many of us for several
months were involved in the front-line ght against the SARS-CoV-2 that is devastating all
of humanity.

Despite this, we managed to move forward with this book and we are proud of
the result.
is book includes three groupings of pleural diseases: malignancies, infectious diseases, and

A large portion of space was reserved for discussion on thoracic ultrasound, an indispensable method for studying the pleura today.

Minimally invasive procedures are widely
addressed, such as thoracentesis, placement of thoracic tubes, and thoracoscopy.
is book is organized as a collection of clinical cases of patients with pleural disease or injury,
who were managed in respiratory care units.

e description of each case includes the onset of
symptoms, the entire diagnostic-therapeutic path, and discussions on the clinical choices made.

e chapters do not describe the best approach possible but what doctors did in certain circum-
stances. Our aim was to introduce the readers to medical real-life cases, allowing them to remem-
ber important clinical lessons and even to learn from errors. A focus on the most relevant issues
is also present.

In addition to the management of pleural diseases, common clinical issues are addressed, such as the management of older patients with multiple morbidities, the optimization of uid balance, and the need to discontinue antiplatelet or anticoagulant therapy before invasive procedures.

A rich iconography embellishes the pages of this volume.

We hope that it will be appreciated and considered educational by readers.

Our hope is that readers will feel like virtual attending physicians and will be stimulated by the clinical reasoning.







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