Issues

Journal & Issues

Volume 70 (2021): Issue 2 (September 2021)

Volume 70 (2021): Issue 1 (June 2021)

Volume 69 (2020): Issue 4 (December 2020)

Volume 69 (2020): Issue 3 (December 2020)

Volume 69 (2020): Issue 2 (December 2020)

Volume 69 (2020): Issue 1 (June 2020)

Volume 68 (2019): Issue 4 (December 2019)

Volume 68 (2019): Issue 3 (December 2019)

Volume 68 (2019): Issue 2 (October 2019)

Volume 68 (2019): Issue 1 (June 2019)

Journal Details
Format
Journal
eISSN
2247-059X
First Published
31 Jan 1951
Publication timeframe
1 time per year
Languages
English

Search

Volume 69 (2020): Issue 3 (December 2020)

Journal Details
Format
Journal
eISSN
2247-059X
First Published
31 Jan 1951
Publication timeframe
1 time per year
Languages
English

Search

11 Articles
Open Access

Summary

Published Online: 30 Aug 2021
Page range: 126 - 127

Abstract

Open Access

Post-COVID-19 infections and evolution of pulmonary and cardiac lesions – the battle has just started

Published Online: 30 Aug 2021
Page range: 128 - 134

Abstract

Abstract

Talking only about the acute phase of COVID-19 infection is not enough. A multitude of complications has arisen after viremia, which has been generating problems for experts. Of these, lung and heart lesions remain important, and interventions, and their prevalence pose real problems for practitioners. The authors analyze these post-COVID-19 complications as well as appropriate recommendations for diagnostic and therapeutic interventions

Keywords

  • post COVID-19 complications
  • pulmonary lesions
  • cardiac lesions
Open Access

Autofluorescence bronchoscopy and lung cancer diagnosis

Published Online: 30 Aug 2021
Page range: 135 - 141

Abstract

Abstract

Lung cancer (LC), is a disease who has increasing prevalence, with a major impact to morbidity and mortality but also significant consumption of resources. The incidence of LC cases is in progression and early diagnosis becomes extremely important in increasing the quality of life and survival. Detection of preneoplastic mucosal lesions can be performed with autofluorescence bronchoscopy (AF). This is not a new method of diagnosis being still in research for standardization and an applicability as easy as possible. AF should be used as a screening method in pacients with suspected LC.

Keywords

  • lung cancer
  • preneoplastic lesions
  • autofluorescence bronchoscopy
  • screening
Open Access

Central sleep apnea in patients with heart failure: whom to screen and how to treat? – A brief review

Published Online: 30 Aug 2021
Page range: 142 - 150

Abstract

Abstract

Central sleep apnoea (CSA) in patients with heart failure (HF) has gained considerable interest in the sleep field within the last decade. Early detection and polysomnography (PSG) patterns recently stated, as well as limited therapeutic approaches remain challenging, that of the positive airway pressure (PAP) therapies show positive effects on cardiovascular mortality in randomised controlled trials (RCTs). The era of personalised medicine promotes further analyses of phenotyping of HF patients for individualised treatment consecutively.

Keywords

  • central sleep apnoea
  • heart failure
  • non-invasive ventilation
  • positive airway pressure
  • oxygen
Open Access

Influenza vaccine in COVID-19 patients: Who?, why?, when?

Published Online: 30 Aug 2021
Page range: 151 - 158

Abstract

Abstract

Considering the increased prevalence of influenza infections in the cold season and the pandemic evolution of severe acute respiratory syndrome-CoV-2 (SARS-CoV-2), the medical staffs are facing potential viral co-infection with SARS-CoV-2 and influenza virus. Both viruses belong to the category of ribonucleic acid (RNA) viruses, having common structural features, causing a similar immune response, with a related mode of transmission and with both respiratory and general symptoms. SARS-CoV-2 and influenza viruses cause contagious infections and the protective measures against them are the same: wearing masks in crowded spaces, proper hand hygiene and avoiding crowded places. Co-infections with influenza A and B viruses and SARS-CoV-2 virus involve additional precautions regarding the therapeutic and evolution approach. Studies show that patients who have been vaccinated against influenza have developed milder forms of confirmed SARS-CoV-2 infection. In elderly patients, increased influenza vaccination coverage has shown to be associated with a decrease in mortality rate and also reduced the heavy impact of double infection. The Influenza vaccine can trigger early immune mechanisms in order to facilitate early detection of SARS-CoV-2 as well as its clearance. Influenza vaccination should now be seen, more than ever, as a strategy to combat the growing SARS-CoV-2 pandemic, especially in vulnerable populations (elderly and people with associated comorbidities).

Keywords

  • SARS-CoV-2
  • Influenza virus
  • vaccination
Open Access

Lung function tests, exercise capacity and postoperative outcomes of patients with pulmonary resections

Published Online: 30 Aug 2021
Page range: 159 - 165

Abstract

Abstract

Aim: Postoperative complications, especially pulmonary complications, are described after lung resections, with different risk factors involved. We evaluate the relationship between lung function, exercise test parameters and the occurrence of postoperative outcomes in patients with pulmonary resections.

Methods: A 5 years prospective observational study on patients with lung resection (lobectomy, bilobectomy and pneumonectomy) for lung cancer and other pulmonary pathologies has been performed. All the patients were preoperatively evaluated using spirometry, plethysmography, diffusing capacity test and cardio-pulmonary exercise test (CPET). Data were analysed regarding the linkage between cardiopulmonary fitness and postoperative outcomes (respiratory complications and 90-day mortality).

Results: Of 155 consecutive patients (109 male, mean age 61.2 ± 9.8 years), 130 (83.9%) underwent pulmonary resection for lung cancer. Nearly 24% of patients developed postoperative respiratory complications (mainly atelectasis, prolonged air leak and respiratory failure). The 90-day mortality was 5.2%. A reduced absolute value of forced expiratory volume in 1 s (FEV1) was found to be associated with postoperative atelectasis [odds ratio (OR) 0.33; 95% confidence interval (CI) 0.11–0.99], but with low accuracy. The most related variable and a predictor to prolonged air leak was FEV1/vital capacity (VC) ratio (OR 0.90; 95% CI 0.83–0.99). Patients who developed respiratory failure had lower values of static volumes and breathing reserve (BR%) compared to those without respiratory failure, but with no significant difference (P > 0.050). No relationship to mortality was noted.

Conclusion: In our study group, lower values of FEV1 were related to postoperative atelectasis and obstructive dysfunction with persistent air leak, with no significant association with mortality.

Keywords

  • lung resection
  • postoperative complications
  • pulmonary function tests
Open Access

Analysis of air pollution exposure in the area of Iasi county – a warning signal for lung health and the risk of developing COPD

Published Online: 30 Aug 2021
Page range: 166 - 173

Abstract

Abstract

Air pollution is a major threat to public health, and the effects of pollution are perceived in all countries of the world, by all social categories, regardless of age. Chronic obstructive pulmonary disease (COPD) has a growing prevalence worldwide and an increasing number of risk factors that exacerbate symptoms and accelerate disease progression. Exposure to air pollution is one of the less studied and less investigated risk factors for COPD. Depending on the size and chemical nature of the pollutant, it can overcome the defence mechanism of the respiratory system and enter the lung tissues, thus causing some respiratory diseases. The World Health Organisation (WHO) reports that six major air pollutants have been identified, namely particulate matter (PM), ground-level ozone, carbon monoxide, sulphur dioxide, nitrogen dioxide and lead. The severe impact of PM exposure is demonstrated by the link between exposure to high concentrations of PM and certain severe diseases such as silicosis, lung cancer, cardiovascular disease and COPD. In Iași County, Romania, air quality measurements are performed by six automatic air quality monitoring stations, and the data obtained are used to create annual reports and these are also available online. Due to the high concentrations of air pollutants, the city of Iași is one of the three topmost polluted cities in Romania. A future assessment on the impact of air pollution on the health of the inhabitants of these cities and the implementation of new methods to improve air quality is needed.

Keywords

  • air pollution
  • COPD
  • PM
Open Access

TB endemic evolution in Romania in the shadow of the SARS-CoV-2 pandemic

Published Online: 30 Aug 2021
Page range: 174 - 181

Abstract

Abstract

The provisory data collected by the tuberculosis (TB) Program in 2020 show that the global incidence decreases by 30%, but considering the long interval from infection to the appearance of clinical manifestations in TB, we will be able to analyse only in the following years the positive or negative impact of the restrictive measures imposed as a result of the SARS-CoV-2 pandemic, on the evolution of TB in Romania.

Keywords

  • Tuberculosis
  • epidemiological data
  • SARS- COV2 pandemic
Open Access

Disseminated Mycobacterium tuberculosis following renal transplant: A case report

Published Online: 30 Aug 2021
Page range: 182 - 185

Abstract

Abstract

Miliary tuberculosis (TB) presents a major challenge following a renal transplant in humans. In the current report, we described a patient with disseminated TB following renal transplantation. The article presents the case of a 38-year-old man who presented an 8-month history of fever, chills, sweating, low-back pain and significant weight loss. Chest radiography and computed tomography (CT) scan showed miliary nodules distributed in the two lungs. The transbronchial lung biopsy revealed a granulomatous reaction with caseous necrosis. Magnetic resonance imaging (MRI) of the brain found multiple tuberculomas. Also, MRI of the lumbosacral was indicative of a psoas abscess. Therefore, miliary pulmonary, cerebral and spinal TB was confirmed. The patient was started on an anti-TB regimen and paravertebral aspiration was also done. The patient’s condition improved considerably. In conclusion, this case report can remind us of the importance of maintaining a high clinical suspicion and performing a thorough workup to establish a timely diagnosis and treatment of miliary TB.

Keywords

  • Mycobacterium tuberculosis
  • renal transplant
  • miliary tuberculosis
Open Access

Hypersensitivity pneumonitis – acceptance of the diagnosis

Published Online: 30 Aug 2021
Page range: 186 - 189

Abstract

Abstract

Hypersensitivity pneumonia (HP) is an inflammatory lung syndrome due to repetitive exposure to small organic particles. The etiological agents of the disease are diverse and can be represented by fungi, bacteria, small molecule chemical compounds, as well as proteins from animals or insects. We present the case of a 25-year-old male, who was admitted to our Pulmonology Clinic for the following symptoms: morning cough with mucosal sputum for about 2 years, moderate exertional dyspnea (mMRC 3) started for 2 months, weight loss of about 6 kg in the past 5 months and fatigue. Clinical examination revealed bilateral mid- basal crackling rales. Chest high-resolution computed tomography (HRCT) (multiple micronodular opacities, diffuse contoured, bilaterally disseminated), lung function tests (restrictive ventilatory dysfunction with decreased carbon monoxide diffusing capacity), bronchoalveolar lavage (BAL) (lymphocyte alveolitis) and serological tests (positive antibodies for pigeon heathers and dejections) pointed to the diagnosis of hypersensitivity pneumonitis. It was recommended to avoid exposure to pigeons, as the patient was a pigeon breeder. Prednisone treatment was initiated. The general condition of the patient 1 month after diagnosis had improved, the evolution being good under treatment.

Keywords

  • hypersensitivity pneumonitis
  • occupational exposure
  • bronchoalveolar lavage
Open Access

Cardiac sarcoidosis: Case report and review of the literature

Published Online: 30 Aug 2021
Page range: 190 - 194

Abstract

Abstract

Sarcoidosis is a rare inflammatory multisystem disease, frequently underdiagnosed and often clinically silent, with a negative prognosis on patient’s survival should the cardiovascular system be involved. This occurs not only due to the direct involvement of the heart and blood vessels but also due to associated organ dysfunctions, most commonly pulmonary sarcoidosis. Cardiac sarcoidosis typically manifests as either conduction disturbances or, less commonly, as tachy- or bradyarrhythmia, sometimes even with signs and/or symptoms of heart failure. In this article, we present the case of a relatively young female patient with few significant comorbidities, who presented to the emergency department for palpitations with a high heart rate, which ultimately turned out to be caused by sustained ventricular tachycardia. The diagnostic steps undertaken thereafter reveal an underlying pulmonary sarcoidosis with cardiac involvement.

Keywords

  • cardiac sarcoidosis
  • ventricular tachycardia
  • cardiovascular magnetic resonance
  • lymph node biopsy
  • corticotherapy
11 Articles
Open Access

Summary

Published Online: 30 Aug 2021
Page range: 126 - 127

Abstract

Open Access

Post-COVID-19 infections and evolution of pulmonary and cardiac lesions – the battle has just started

Published Online: 30 Aug 2021
Page range: 128 - 134

Abstract

Abstract

Talking only about the acute phase of COVID-19 infection is not enough. A multitude of complications has arisen after viremia, which has been generating problems for experts. Of these, lung and heart lesions remain important, and interventions, and their prevalence pose real problems for practitioners. The authors analyze these post-COVID-19 complications as well as appropriate recommendations for diagnostic and therapeutic interventions

Keywords

  • post COVID-19 complications
  • pulmonary lesions
  • cardiac lesions
Open Access

Autofluorescence bronchoscopy and lung cancer diagnosis

Published Online: 30 Aug 2021
Page range: 135 - 141

Abstract

Abstract

Lung cancer (LC), is a disease who has increasing prevalence, with a major impact to morbidity and mortality but also significant consumption of resources. The incidence of LC cases is in progression and early diagnosis becomes extremely important in increasing the quality of life and survival. Detection of preneoplastic mucosal lesions can be performed with autofluorescence bronchoscopy (AF). This is not a new method of diagnosis being still in research for standardization and an applicability as easy as possible. AF should be used as a screening method in pacients with suspected LC.

Keywords

  • lung cancer
  • preneoplastic lesions
  • autofluorescence bronchoscopy
  • screening
Open Access

Central sleep apnea in patients with heart failure: whom to screen and how to treat? – A brief review

Published Online: 30 Aug 2021
Page range: 142 - 150

Abstract

Abstract

Central sleep apnoea (CSA) in patients with heart failure (HF) has gained considerable interest in the sleep field within the last decade. Early detection and polysomnography (PSG) patterns recently stated, as well as limited therapeutic approaches remain challenging, that of the positive airway pressure (PAP) therapies show positive effects on cardiovascular mortality in randomised controlled trials (RCTs). The era of personalised medicine promotes further analyses of phenotyping of HF patients for individualised treatment consecutively.

Keywords

  • central sleep apnoea
  • heart failure
  • non-invasive ventilation
  • positive airway pressure
  • oxygen
Open Access

Influenza vaccine in COVID-19 patients: Who?, why?, when?

Published Online: 30 Aug 2021
Page range: 151 - 158

Abstract

Abstract

Considering the increased prevalence of influenza infections in the cold season and the pandemic evolution of severe acute respiratory syndrome-CoV-2 (SARS-CoV-2), the medical staffs are facing potential viral co-infection with SARS-CoV-2 and influenza virus. Both viruses belong to the category of ribonucleic acid (RNA) viruses, having common structural features, causing a similar immune response, with a related mode of transmission and with both respiratory and general symptoms. SARS-CoV-2 and influenza viruses cause contagious infections and the protective measures against them are the same: wearing masks in crowded spaces, proper hand hygiene and avoiding crowded places. Co-infections with influenza A and B viruses and SARS-CoV-2 virus involve additional precautions regarding the therapeutic and evolution approach. Studies show that patients who have been vaccinated against influenza have developed milder forms of confirmed SARS-CoV-2 infection. In elderly patients, increased influenza vaccination coverage has shown to be associated with a decrease in mortality rate and also reduced the heavy impact of double infection. The Influenza vaccine can trigger early immune mechanisms in order to facilitate early detection of SARS-CoV-2 as well as its clearance. Influenza vaccination should now be seen, more than ever, as a strategy to combat the growing SARS-CoV-2 pandemic, especially in vulnerable populations (elderly and people with associated comorbidities).

Keywords

  • SARS-CoV-2
  • Influenza virus
  • vaccination
Open Access

Lung function tests, exercise capacity and postoperative outcomes of patients with pulmonary resections

Published Online: 30 Aug 2021
Page range: 159 - 165

Abstract

Abstract

Aim: Postoperative complications, especially pulmonary complications, are described after lung resections, with different risk factors involved. We evaluate the relationship between lung function, exercise test parameters and the occurrence of postoperative outcomes in patients with pulmonary resections.

Methods: A 5 years prospective observational study on patients with lung resection (lobectomy, bilobectomy and pneumonectomy) for lung cancer and other pulmonary pathologies has been performed. All the patients were preoperatively evaluated using spirometry, plethysmography, diffusing capacity test and cardio-pulmonary exercise test (CPET). Data were analysed regarding the linkage between cardiopulmonary fitness and postoperative outcomes (respiratory complications and 90-day mortality).

Results: Of 155 consecutive patients (109 male, mean age 61.2 ± 9.8 years), 130 (83.9%) underwent pulmonary resection for lung cancer. Nearly 24% of patients developed postoperative respiratory complications (mainly atelectasis, prolonged air leak and respiratory failure). The 90-day mortality was 5.2%. A reduced absolute value of forced expiratory volume in 1 s (FEV1) was found to be associated with postoperative atelectasis [odds ratio (OR) 0.33; 95% confidence interval (CI) 0.11–0.99], but with low accuracy. The most related variable and a predictor to prolonged air leak was FEV1/vital capacity (VC) ratio (OR 0.90; 95% CI 0.83–0.99). Patients who developed respiratory failure had lower values of static volumes and breathing reserve (BR%) compared to those without respiratory failure, but with no significant difference (P > 0.050). No relationship to mortality was noted.

Conclusion: In our study group, lower values of FEV1 were related to postoperative atelectasis and obstructive dysfunction with persistent air leak, with no significant association with mortality.

Keywords

  • lung resection
  • postoperative complications
  • pulmonary function tests
Open Access

Analysis of air pollution exposure in the area of Iasi county – a warning signal for lung health and the risk of developing COPD

Published Online: 30 Aug 2021
Page range: 166 - 173

Abstract

Abstract

Air pollution is a major threat to public health, and the effects of pollution are perceived in all countries of the world, by all social categories, regardless of age. Chronic obstructive pulmonary disease (COPD) has a growing prevalence worldwide and an increasing number of risk factors that exacerbate symptoms and accelerate disease progression. Exposure to air pollution is one of the less studied and less investigated risk factors for COPD. Depending on the size and chemical nature of the pollutant, it can overcome the defence mechanism of the respiratory system and enter the lung tissues, thus causing some respiratory diseases. The World Health Organisation (WHO) reports that six major air pollutants have been identified, namely particulate matter (PM), ground-level ozone, carbon monoxide, sulphur dioxide, nitrogen dioxide and lead. The severe impact of PM exposure is demonstrated by the link between exposure to high concentrations of PM and certain severe diseases such as silicosis, lung cancer, cardiovascular disease and COPD. In Iași County, Romania, air quality measurements are performed by six automatic air quality monitoring stations, and the data obtained are used to create annual reports and these are also available online. Due to the high concentrations of air pollutants, the city of Iași is one of the three topmost polluted cities in Romania. A future assessment on the impact of air pollution on the health of the inhabitants of these cities and the implementation of new methods to improve air quality is needed.

Keywords

  • air pollution
  • COPD
  • PM
Open Access

TB endemic evolution in Romania in the shadow of the SARS-CoV-2 pandemic

Published Online: 30 Aug 2021
Page range: 174 - 181

Abstract

Abstract

The provisory data collected by the tuberculosis (TB) Program in 2020 show that the global incidence decreases by 30%, but considering the long interval from infection to the appearance of clinical manifestations in TB, we will be able to analyse only in the following years the positive or negative impact of the restrictive measures imposed as a result of the SARS-CoV-2 pandemic, on the evolution of TB in Romania.

Keywords

  • Tuberculosis
  • epidemiological data
  • SARS- COV2 pandemic
Open Access

Disseminated Mycobacterium tuberculosis following renal transplant: A case report

Published Online: 30 Aug 2021
Page range: 182 - 185

Abstract

Abstract

Miliary tuberculosis (TB) presents a major challenge following a renal transplant in humans. In the current report, we described a patient with disseminated TB following renal transplantation. The article presents the case of a 38-year-old man who presented an 8-month history of fever, chills, sweating, low-back pain and significant weight loss. Chest radiography and computed tomography (CT) scan showed miliary nodules distributed in the two lungs. The transbronchial lung biopsy revealed a granulomatous reaction with caseous necrosis. Magnetic resonance imaging (MRI) of the brain found multiple tuberculomas. Also, MRI of the lumbosacral was indicative of a psoas abscess. Therefore, miliary pulmonary, cerebral and spinal TB was confirmed. The patient was started on an anti-TB regimen and paravertebral aspiration was also done. The patient’s condition improved considerably. In conclusion, this case report can remind us of the importance of maintaining a high clinical suspicion and performing a thorough workup to establish a timely diagnosis and treatment of miliary TB.

Keywords

  • Mycobacterium tuberculosis
  • renal transplant
  • miliary tuberculosis
Open Access

Hypersensitivity pneumonitis – acceptance of the diagnosis

Published Online: 30 Aug 2021
Page range: 186 - 189

Abstract

Abstract

Hypersensitivity pneumonia (HP) is an inflammatory lung syndrome due to repetitive exposure to small organic particles. The etiological agents of the disease are diverse and can be represented by fungi, bacteria, small molecule chemical compounds, as well as proteins from animals or insects. We present the case of a 25-year-old male, who was admitted to our Pulmonology Clinic for the following symptoms: morning cough with mucosal sputum for about 2 years, moderate exertional dyspnea (mMRC 3) started for 2 months, weight loss of about 6 kg in the past 5 months and fatigue. Clinical examination revealed bilateral mid- basal crackling rales. Chest high-resolution computed tomography (HRCT) (multiple micronodular opacities, diffuse contoured, bilaterally disseminated), lung function tests (restrictive ventilatory dysfunction with decreased carbon monoxide diffusing capacity), bronchoalveolar lavage (BAL) (lymphocyte alveolitis) and serological tests (positive antibodies for pigeon heathers and dejections) pointed to the diagnosis of hypersensitivity pneumonitis. It was recommended to avoid exposure to pigeons, as the patient was a pigeon breeder. Prednisone treatment was initiated. The general condition of the patient 1 month after diagnosis had improved, the evolution being good under treatment.

Keywords

  • hypersensitivity pneumonitis
  • occupational exposure
  • bronchoalveolar lavage
Open Access

Cardiac sarcoidosis: Case report and review of the literature

Published Online: 30 Aug 2021
Page range: 190 - 194

Abstract

Abstract

Sarcoidosis is a rare inflammatory multisystem disease, frequently underdiagnosed and often clinically silent, with a negative prognosis on patient’s survival should the cardiovascular system be involved. This occurs not only due to the direct involvement of the heart and blood vessels but also due to associated organ dysfunctions, most commonly pulmonary sarcoidosis. Cardiac sarcoidosis typically manifests as either conduction disturbances or, less commonly, as tachy- or bradyarrhythmia, sometimes even with signs and/or symptoms of heart failure. In this article, we present the case of a relatively young female patient with few significant comorbidities, who presented to the emergency department for palpitations with a high heart rate, which ultimately turned out to be caused by sustained ventricular tachycardia. The diagnostic steps undertaken thereafter reveal an underlying pulmonary sarcoidosis with cardiac involvement.

Keywords

  • cardiac sarcoidosis
  • ventricular tachycardia
  • cardiovascular magnetic resonance
  • lymph node biopsy
  • corticotherapy

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