<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec>
<h3>CASE REPORTS</h3>
<p><bold>Unusual cause of bronchiolitis obliterans in an immunosuppressed patient</bold> – Ana-Lavinia Neacșu, Inna Dencheva Ruseva, Ionuț Hallabrin, Cătălina Ene, Diana Leonte, Claudia Toma</p>
<p><bold>First report of a case of negative-pressure pulmonary edema during pregnancy</bold> – Mohammad Hossein Rahimirad, Bahman Naghipour, Shaghayegh Rahimirad, Mohammad Reza Ghaffary</p>
<p><bold>Large pulmonary metastasis or primary lung cancer? Management particularities of an osteosarcoma case</bold> – Nicolae Demenciuc, Iuliu Gabriel Cocuz, Ovidiu Simion Cotoi, Rodica Demenciuc, Budin Eugenia Corina</p>
<p><bold>Primary ciliary dyskinesia diagnosis management in low-resource setting, a practical approach</bold> – Andreea Dumitroae, Ion Alexandru Voropanov, Ramona Elena Slăvulete, Valentina-Daniela Comănici, Mihai Craiu, Iustina Violeta Stan</p>
</sec>
<sec>
<h3>GENERAL REVIEW</h3>
<p><bold>Lopinavir-ritonavir for SARS-CoV-2 infection: a systematic review</bold> – Oana Raduna, Bianca Stepan, Emanuel Bobu, Andreea Blidaru, Bianca Cerbu, Iosif Marincu, Stefan Frent</p>
</sec>
<sec>
<h3>EDITORIAL</h3>
<p><bold>Mesothelioma Diagnosis: A Comprehensive Guideline-based Approach</bold> – Tudor P. Toma</p>
</sec>
</abstract>

Summary

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Bronchiolitis obliterans organizing pneumonia (BOOP) is a diffuse interstitial lung disease, currently classified as cryptogenic organizing pneumonia (COP) when idiopathic, respectively organizing pneumonia (OP) in case of a specified etiology.</p>
<p>We present the case of a 48-year-old patient, former smoker (20PY), diabetic, who accused moderate dyspnea, persistent febrile syndrome. The chest radiography showed multiple areas of condensation distributed bilaterally diffusely and the laboratory data revealed an important inflammatory syndrome. More than 100 colonies of Candida albicans were isolated from the sputum, therefore antifungal therapy was initiated. The computer tomography scan (CT scan) highlighted multiple micronodular and nodular lesions, some with tendency of excavation and hydroaeric level present and a polyseptate lesion in the right lower lobe; no proliferative elements were found during bronchoscopy and the bronchoalveolar lavage was non-specific; To obtain a final diagnosis, a CT-guided transthoracic needle biopsy was performed and the histological examination was compatible with organized pneumonia.</p>
</abstract>

Unusual cause of bronchiolitis obliterans in an immunosuppressed patient

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Negative-pressure pulmonary edema (NPPE) or postobstructive pulmonary edema (POPE) is a rare but life-threatening complication in the perioperative and critical care settings. In this study, we present the first case of NPPE in a pregnant woman.</p>
<sec>
<h3>Case presentation</h3>
<p>A 39-year-old 31-week pregnant woman underwent transurethral lithotripsy. She had respiratory distress about 10 minutes after extubation. Chest imaging confirmed pulmonary edema. The patient was managed in the intensive care unit (ICU) with intravenous furosemide supplemental oxygen. Evaluations showed no heart failure, but laboratory tests confirmed the presence of primary hyperparathyroidism. She was discharged on 5th day without complication.</p>
</sec>
<sec>
<h3>Conclusion</h3>
<p>In this study, we reported the first case of NPPE in a pregnant woman. NPPE should be considered in differential diagnosis of respiratory distress during pregnancy.</p>
</sec>
</abstract>

First report of a case of negative-pressure pulmonary edema during pregnancy

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Osteosarcoma is the most frequent malignant tumor of the bone which is diagnosed most frequently in children or young adults, with a high possibility of metastasis, especially in the lung. We report a case of 39-year male patient with a history of an above-the-knee left limb amputation after tibial osteosarcoma with no follow-ups in the last two years and with an expansive apical and left paramediastinal mass found on chest X-ray. We performed a bronchoscopy and the histopathological diagnosis of swabbed samples was fibroblastic type of classic osteosarcoma with focal areas of telangiectatic osteosarcoma and areas showing giant cells. The particularity of the case consisted in the challenge of establishing the origin of pulmonary mass. Whilst increased dimensions militated for a primary pulmonary neoplasm, the histological examination ascertained the metastatic etiology of the tumor.</p>
</abstract>

Large pulmonary metastasis or primary lung cancer? Management particularities of an osteosarcoma case

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Primary ciliary dyskinesia (PCD) is a congenital disorder with genetic determinism, characterized by chronic infections of the upper and lower respiratory tract. The triad of situs inversus, chronic sinusitis and bronchiectasis is called Kartagener Syndrome. PCD is a predominantly autosomal recessive disease, involving more than 40 mutations of genes. Abnormal cilia movement leads to defective mucociliary clearance resulting in chronic cough, nasal congestion, recurrent otitis, chronic sinusitis, male infertility and other rare conditions. First presented case is one of a 17-year-old girl with chronic treatment for asthma for the last 5 years. Respiratory functional tests were performed: the patient didn’t present variable airflow obstruction. The diagnosis of PCD was suspected because of chronic respiratory infections in a situs-inversus patient. The second case is a 4-year-old patient with a clinical history highly suggestive of ciliary dyskinesia, who received a recommendation for genetic testing to confirm the diagnosis. The third case is an 8-year-old boy with wet cough from neonatal period, bronchiectasis and sinusitis. Both his symptoms and the fact that his adult brother presented situs inversus, chronic sinusitis and bronchiectasis led us to raise suspicion of PCD. These case reports aim to highlight the real-life difficulties in a rather low-resource setting in diagnosing PCD, a genetic syndrome with long term impact on airways. The second objective was outlining the clinical manifestations that are highly suggestive of PCD and also to develop a diagnostic algorithm for a real-life scenario involving a pulmonologist with reduced access to high-performance tools like TEM (transmission electron microscopy) and complex genetic tests. Because not all PCD cases have known genetic mutations and some don’t have ultrastructural abnormalities we could still rely on the old saccharin test in order to select patients that are candidates for nasal NO. A high index of suspicion for PCD should be present in any patient with non-cystic fibrosis bronchiectasis patient. PCD remains a rare and underdiagnosed genetic syndrome in real-life paediatric setting in countries with limited neonatal screening programs. Increasing awareness of this condition and accessible diagnostic tools are desirable in order to find patients with high-likelihood of PCD and to refer these selected patients to specialized centres. Authors provide an age-dependent approach of PCD patients in a low resource setting.</p>
</abstract>

Primary ciliary dyskinesia diagnosis management in low-resource setting, a practical approach

<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec>
<h3>Background</h3>
<p>SARS-CoV-2 is a new virus that first emerged in Wuhan, China in December 2019. The virus quickly spread throughout the countries, transforming the initial outbreak into a global pandemic. Lopinavir-ritonavir is an antiretroviral protease inhibitor combination drug that was proposed for the treatment of COVID-19 in the early phases of the pandemic. We conducted a systematic literature search on clinical trials assessing the efficacy and safety of lopinavir-ritonavir in patients hospitalized for COVID-19. 10 studies satisfying the inclusion criteria were analyzed and discussed in the current review. Four studies were randomized controlled trials, while the remaining had an observational design. The reported results are mixed, with some of the studies demonstrating the benefits of the combination drug, while others show little or no effect. These contradictory reports may be explained by the differences in study design, study population, the onset of treatment, and severity of disease, rendering this topic a subject for further debate.</p>
</sec>
</abstract>

Lopinavir-ritonavir for SARS-CoV-2 infection: a systematic review

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Mesothelioma is a rare and aggressive cancer that affects the lining of the lungs, abdomen, or heart. Early diagnosis and treatment are essential for optimizing survival and quality of life for patients with mesothelioma. The article aims to offer a clear and practical perspective on the guidelines for diagnosing mesothelioma. Our goal is to provide clinicians with a comprehensive guide on how to diagnose and manage this condition effectively. We will examine key aspects such as the prompt acquisition of tissue samples, the significance of imaging and biopsy techniques in the diagnostic process, and the utilization of biomarkers to raise suspicion of mesothelioma. Additionally, we emphasize the essentiality of adopting a multidisciplinary approach to patient care, encompassing holistic support for both patients and their families. The paper aims to offer a comprehensive overview for clinicians working in general hospitals who are required to diagnose mesothelioma. The suggestions provided are based on current international guidelines, which should be adapted to suit local clinical practices. By addressing this need, we hope to assist clinicians in effectively diagnosing mesothelioma within their specific healthcare settings.</p>
</abstract>

Mesothelioma Diagnosis: A Comprehensive Guideline-based Approach

AHEAD OF PRINT

Volume 71 (2022): Issue 4 (December 2022)

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Pneumologia

 Pneumologia is the journal of the Romanian Society of Pneumology, being continuously edited since 1951. Pneumologia is an open-access journal, edited in English, 4 issues per year and is included in international databases. It publishes clinical and experimental research articles in the field of respiratory medicine, paediatrics, thoracic surgery, allergology, respiratory intensive care and oncology.  Pneumologia aims to publish scientifically valid papers, related to the respiratory field, offering a good visibility of the published papers. It is also an educational platform for physicians, educators interested in this domain, and aims to promote research and good clinical practice.  Pneumologia publishes original articles in the field of respiratory medicine, paediatrics, thoracic surgery, allergology, respiratory intensive care, and oncology. The following types of submissions are accepted:   Original research papers  Case reports  Reviews  Letters to the editor  Educational materials: practice guidelines, new techniques description and use  News, chronicles   All submitted papers are confidentially peer-reviewed in a timely manner, by at least two independent reviewers selected according to the topic of the article. The peer-review process aims to check the originality, scientific validity, and coherence of the submission.  Pneumologia offers fast publication; the eligible submissions are typically published within 3 months. There is no publication fee, and the online version is available open access on the Journal’s web site. The printed journal is distributed to the members of the Romanian Society of Pneumology and several public libraries.  Romanian and international authors are welcome to submit papers to Pneumologia, which is one of the few journals specifically dedicated to respiratory medicine in the region.  Archiving  Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.  Plagiarism Policy  The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process.  Back issues www.pneumologia.eu/en/all-articles arhiva.pneumologia.eu/ 