The features of bronchoalveolar lavage fluid (BALF) components and the severity of pulmonary alve... more The features of bronchoalveolar lavage fluid (BALF) components and the severity of pulmonary alveolar proteinosis (PAP) were analyzed in the first Romanian cohort of patients admitted to "Marius Nasta" Institute of Pneumophtisiology, Bucharest, Romania. A six-year follow-up study based on bronchoalveolar lavage (BAL) data was performed between January 2007 to December 2012. Study cohort consisted in 20 inpatients diagnosed with PAP, based on BALF cytological findings and÷or on histopathological findings. Demographic, medical history, tobacco use, clinical and radiological features, disease progression with or without whole lung lavage (WLL) therapy were collected. Disease severity was evaluated by pulmonary function testing including spirometry, blood gas analysis, plethysmography, and diffusing capacity of the lung for carbon monoxide (DLCO), also known as transfer factor (TLCO). The cellular profile of all BALF specimens was analyzed. Statistical analysis made by SPSS version 17.0 included Student's t-test, chi-square test and ANOVA. Mean age of the subjects was 43±16.59 years, with male predominance (n=12; 60%). Diagnosis of PAP was facilitated by fiberbronchoscopy (FBS) with BAL in 90% of cases. Cytological findings of BALF revealed lower macrophages (57.26±18.19%), with a preponderance of neutrophils (17.75±19.44%) and lymphocytes (21.8±16.12%). Lower oxygen partial pressure was identified in elders, comparing to younger patients (p=0.038). Patients treated by WLL had a lower total lung capacity (TLC) and DLCO versus those who did not required WLL (p=0.009, respectively p=0.056). The severity of pulmonary abnormalities provided WLL indication was not influenced by BALF cellularity.
Asbestos is a mineral-mined form the rocks, consisting in amosite (brown asbestos), crocidolite (... more Asbestos is a mineral-mined form the rocks, consisting in amosite (brown asbestos), crocidolite (blue asbestos) and÷or chrysotile (white asbestos) used in many industries. Researches about the exposure to asbestos dust and asbestosis related diseases started almost a century ago. The first case report of fatal asbestosis disease was published in 1906, in England, by Dr. Hubert Montague Murray. A decade after, asbestos "curious bodies" were firstly described in the lung tissue by Cooke (1926) and McDonald (1927). Occupational exposure to asbestos is now regulated in Romania, but past exposure is still a cause of asbestosis-related diseases (ARDs), including lung cancer. A peculiar association between a lung adenocarcinoma, a previously healed pulmonary tuberculosis (PTB) disease, is reported in a 61-year-old nonsmoker white man, a former factory worker with 29 years of occupational exposure history to cement and asbestos fibers. The positive diagnosis of asbestos exposure was facilitated by asbestos bodies determined in bronchoalveolar lavage fluid. The main purpose of this case report is to describe the development of a right pleural effusion which was not revelatory for a mesothelioma but for an adenocarcinoma of the lung. An accurate morphologic and immunohistochemistry assessment of a pleural biopsy sample excluded mesothelioma and was crucial in the positive diagnosis of adenocarcinoma. In conclusion, unilateral paraneoplastic pleural effusion in a nonsmoker male with occupational exposure to asbestosis fibers was suggestive for adenocarcinoma related asbestosis of the lung. Lung cancer and malignant pleural exudate developed after a long latency cumulative retention time of asbestos fibers.
International Journal of Chronic Obstructive Pulmonary Disease, Sep 1, 2021
This study assessed the characteristics and the relationship between symptoms in any part of the ... more This study assessed the characteristics and the relationship between symptoms in any part of the 24-hour (24-h) day, physical activity level (PAL), and other clinical and functional outcomes in stable COPD patients. Patients and Methods: Out of the 2162 patients enrolled in the SPACE study (The Symptoms and Physical Activity in COPD patients in Europe, clinicaltrials.gov NCT03031769), 406 (18.8%) were recruited from Romania. Here, we present the Romanian cohort results. Eligible patients were adults with age at least 40 years, confirmed diagnosis of stable COPD, current or former smokers with a smoking history of minimum 10 pack-years. The 24-h respiratory symptoms were assessed using Early Morning Symptoms of COPD Instrument (EMSCI), Evaluating Respiratory Symptoms in COPD (E-RS™: COPD) and Nighttime Symptoms of COPD Instrument (NiSCI). During clinical interview, patients self-evaluated PAL through Exercise as Vital Sign (EVS) and Yale Physical Activity Survey (YPAS). Physicians assessed PAL through their clinical judgment. Results: For each combination of 2 between the early morning (EM), daytime (DT) and night-time (NT) symptoms of the 24-h day, there was a significant association (p < 0.001 for each). All symptoms significantly correlated with exacerbation history (p < 0.001 for EM and NT, p=0.002 for DT), and number of severe exacerbations (p < 0.001 for DT, p=0.001 for EM and p=0.026 for NT, respectively). The 24-h symptoms correlated negatively and significantly with PAL (p < 0.001), irrespective of the assessment used. Self-reported PAL negatively correlated with dyspnea, symptom burden, severity of disease and number of exacerbations (p < 0.001). Patients spent an average (standard deviation) of 25.8 (21.0) hours/week performing physical activity. Physicians overestimated their patients' daily PAL. Conclusion: A negative and significant correlation between the 24-h day symptoms and PAL was identified in stable COPD patients. Physicians need to routinely assess PAL using adequate tools and start educating inactive COPD patients to optimize their disease outcomes.
The serum enzymes are ideal diagnostic or prediction markers. Aspartate aminotransferase (AST), a... more The serum enzymes are ideal diagnostic or prediction markers. Aspartate aminotransferase (AST), a mitochondrial and cytoplasmic enzyme, is one of the well-known markers of hepatic, myocardial or skeletal muscle cytolysis, while alanine aminotransferase (ALT) is mainly a hepatic cytoplasmic enzyme. The normal plasmatic values of AST and of ALT reflect a physiological cell turnover. Therefore, both high and low levels of serum liver enzymes might have a clinical significance. We have conducted a retrospective study targeting the association between the serum AST and ALT levels and the lung function impairment among patients with occupational asthma but without hepatic, cardiac, renal or muscular disorders. Our data show a significant relation (R = 0.54, p <0.05) between the parameters of obstructive ventilator syndrome and AST and ALT levels, respectively (R =0.42, p <0.05). If this relation is confirmed in prospective studies, serum AST and ALT could become useful markers in monitoring asthma patients.
International Journal of Molecular Sciences, Aug 20, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Romanian Journal of Occupational Medicine, Aug 27, 2020
The definition of COVID-19 as occupational disease follows the investigation of any other occupat... more The definition of COVID-19 as occupational disease follows the investigation of any other occupational disease caused by an infectious agent. The risk is not equal for all occupations and the occupational physician has to assess the working conditions to conclude a diagnosis of occupational COVID-19. In the pandemic context, employees face also other occupational hazards. The high level of work load and the scarce resources lead to stress, physical and mental exhaustion and irregular sleep. The protection measures, of undisputable benefit, increase the risk for contact dermatitis. There is a high probability for medium and possible long term effects of COVID-19, such as the post-traumatic stress disorder or the respiratory sequelae. These consequences need to be acknowledged and properly manged by the medical team taking care of the patient. This review presents the main characteristics of the occupational related disorders during and after the current pandemia.
Respiratory symptoms significantly impact daily activities and quality of life of patients with c... more Respiratory symptoms significantly impact daily activities and quality of life of patients with chronic obstructive pulmonary disease (COPD). A multidimensional construct, physical activity emerged as an important functional outcome in COPD based on constant association with exacerbations and mortality. This study aimed to describe the prevalence and severity of respiratory symptoms, physical activity level and their relationship in stable COPD patients.
Alpha-1 antitrypsin deficiency (AATD) is an underdiagnosed genetic disorder that manifests primar... more Alpha-1 antitrypsin deficiency (AATD) is an underdiagnosed genetic disorder that manifests primarily through pulmonary and hepatic impairment. In Romania, a targeted detection program testing for AATD was implemented between October 2012 and October 2016. A cohort study enrolled all patients with indication for AATD screening (lung or liver disease, adults and children, index and non-index cases). Testing methods were mainly represented by isoelectric focusing, genotyping and/or sequencing. 620 patients (21 children) were tested (median age 50.0�16.4 years, 58.1% men), 91.9% of proved normal. A total of 50 patients were identified to be carrying a modified genotype (26 men). Hardy-Weinberg equilibrium was used for assessing the frequency of the genetic abnormalities: 1/1.08 PiMM, 1/32 PiMS, 1/28 PiMZ, 1/48 M-rare allele heterozygote, 1/3906 PiSS, 1/2770 PiZZ, 1/1000 PiSZ and 1/12346 for a Z-rare allele heterozygote. Severe AATD was present with a 1% frequency. Prevalence of abnormal...
ABSTRACT Abstract. Lung cancer in never-smokers is a common causes of morbidity and mortality. Th... more ABSTRACT Abstract. Lung cancer in never-smokers is a common causes of morbidity and mortality. The aim of the research was to summarise the impact of environmental risk factors on the occurrence of lung cancer in never-smokers. For this purpose, a prevalence study was conducted from 01.01.2008 to 31.12.2011, in non-smokers adults diagnosed with lung cancer. After inform consented, a simplified screening questionnaire based on demographic data, smoking, indoor and environmental air pollutants, including radon, occupational exposure and medical history was applied. Study population consists in 100 never-smokers mean aged 54.04-year old, with a male preponderence (54%), and urban residence (31%). There were identified exposure to radon gas inside buildings near uranium mines of the Stei- Baita area (19%); indoor air pollution from solid fuels, oil vapours and smoke, coal smoke (5%); work-related exposure to asbestos and coal dust, carbon ash, silica, glass fibres, metals, vapour of chemical pollutants, or fumes of polymers (23%), agricultural pesticide (8%) and, most of all, second-hand tobacco smoking (67%). Tuberculosis and CO PD were related with adenocarcinoma, respectively epidermoid carcinoma. Environmental air pollutants could be implicated in the etiology of lung cancer, but more than a half of participants had also second-hand smoking exposure. Keywords: lung cancer, never-smokers, environmental pollutants, radon, second-hand smoking.
PURPOSE: Our study tries to estimate the influence of smoking on serum levels of thyroid hormones... more PURPOSE: Our study tries to estimate the influence of smoking on serum levels of thyroid hormones, antithyroid peroxidase and antithyroglobulin antibodies among women with various clinical forms of chronic autoimmune thyroiditis.
INTRODUCTION: To reveal the risk of pulmonary hamartoma mimicking pulmonary tuberculoma. To explo... more INTRODUCTION: To reveal the risk of pulmonary hamartoma mimicking pulmonary tuberculoma. To explore the varied and unusual, clinical and radiological pattern of pulmonary hamartoma.
The objective was to compare the improvement of quality of life (QoL) between smokers with chroni... more The objective was to compare the improvement of quality of life (QoL) between smokers with chronic obstructive pulmonary disease (COPD) who completed a PR program complementary of the smoking cessation treatment and those who received usual treatment. Methods: Inclusion criteria were: evidence of COPD according to GOLD standards; an initial HbCO > 2% and an initial COPD Assessment Test (CAT) completed by every patient. From 437 smokers with COPD (GOLD stages II-III) only 113 pacients were enrolled in a 12 weeks supervised PR program, complementary the smoking cessation treatment (the PR group), and 324 smokers received the treatment for COPD and for stop smoking, monitorized as well for 12 weeks (non-PR group). All pacients completed the CAT questionnaire at the beginning and at the end of the determined period. Results: Initially, CAT scores varied between 26-38 without any diferrence between the PR group and the other patients. At the end of the period, the CAT scores in the PR group were between 7-16 comparing to the non-PR group where CAT scores shown little improvements since the beginning of the treatment, with values between 20-26, additionally to smoking cessation failure at an important number of non-PR members (45.98%) than the PR group (16.81%). There were reported as well higher rates of long-term abstinence in the pacients adherent to PR than the other group. Conclusions: Although current smokers are often expected to have a small PR adherence, COPD smokers who completed the PR presented important QoL improvements, better CAT score than COPD smokers usually treated. Moreover, a better PR adherence seems to be related with higher rates of sustained long term abstinence.
Background. Rheumatoid arthritis (RA) is a systemic inflammatory disease, associated with a numbe... more Background. Rheumatoid arthritis (RA) is a systemic inflammatory disease, associated with a number of extra-articular organ manifestations. Pulmonary involvement is a frequent and severe extraarticular manifestations of rheumatoid arthritis. RA can affect lung parenchyma, airways and pleura. Objectives. To identify RA-related lung disease on chest computed tomography (CT). Material and methods. We performed high-resolution computed tomography (HRCT) on a total of 92 patients with longstanding RA. Results. The subjects were predominantely female (79.3%), the age at entry was 63.77 ±11.56 years, and 42.9% had a history of smoking. Disease duration was 15.00±11.55 years. Pulmonary CT abnormalities were found in 71 of the 92 patients (77.2%). The most common HRCT anomalies were: linear attenuation (reticulation) (52.11%), bronchiectasis andbronchial wall thickening (45%), nodular attenuation (39.43%) and pleural involvement (pleural effusion or thickening) (39.43%). Conclusions. We conclude that RA-related lung disease was commonly detected on chest CT imaging in longstanding RA patients.
Sleep apnea episodes represent a problem both for the patients and for the patient's bed partners... more Sleep apnea episodes represent a problem both for the patients and for the patient's bed partners. The objective of this study was to record the comparative effects of two types of polymeric appliances in the therapy of some mild apnea symptoms (bruxism and snoring). The effect of therapy with the used appliances was pursued on 42 patients, divided in two groups. In the first group of 21 patients, we used a custom made appliance achieved by Erkoflex disks, and in the second group of 21 patients, the preformed SomnoFit®-Oscimed polymeric appliance. The survey lasted for a 12 month period, 1 month before the insertion in mouth of the appliances and 11 months therapy with polymeric appliances. The authors' questionnaire was completed daily by the patients and their bed partners, which noted the night comfort with inserted appliances in the mouth, the existence/absence of morning pain in the area of the masseter muscle, existence/absence of the morning fatigue, respectively the maintaining, diminishing and the absence of snoring and of nocturnal bruxism. The results of the study were favorable and proved that the nocturnal therapy of bruxism and of snoring, by using these two polymeric appliances were efficient. SomnoFit® appliance performed better in reducing bruxism and snoring, but custom made Erkoflex appliances presented a greater resistance in time.
The features of bronchoalveolar lavage fluid (BALF) components and the severity of pulmonary alve... more The features of bronchoalveolar lavage fluid (BALF) components and the severity of pulmonary alveolar proteinosis (PAP) were analyzed in the first Romanian cohort of patients admitted to "Marius Nasta" Institute of Pneumophtisiology, Bucharest, Romania. A six-year follow-up study based on bronchoalveolar lavage (BAL) data was performed between January 2007 to December 2012. Study cohort consisted in 20 inpatients diagnosed with PAP, based on BALF cytological findings and÷or on histopathological findings. Demographic, medical history, tobacco use, clinical and radiological features, disease progression with or without whole lung lavage (WLL) therapy were collected. Disease severity was evaluated by pulmonary function testing including spirometry, blood gas analysis, plethysmography, and diffusing capacity of the lung for carbon monoxide (DLCO), also known as transfer factor (TLCO). The cellular profile of all BALF specimens was analyzed. Statistical analysis made by SPSS version 17.0 included Student's t-test, chi-square test and ANOVA. Mean age of the subjects was 43±16.59 years, with male predominance (n=12; 60%). Diagnosis of PAP was facilitated by fiberbronchoscopy (FBS) with BAL in 90% of cases. Cytological findings of BALF revealed lower macrophages (57.26±18.19%), with a preponderance of neutrophils (17.75±19.44%) and lymphocytes (21.8±16.12%). Lower oxygen partial pressure was identified in elders, comparing to younger patients (p=0.038). Patients treated by WLL had a lower total lung capacity (TLC) and DLCO versus those who did not required WLL (p=0.009, respectively p=0.056). The severity of pulmonary abnormalities provided WLL indication was not influenced by BALF cellularity.
Asbestos is a mineral-mined form the rocks, consisting in amosite (brown asbestos), crocidolite (... more Asbestos is a mineral-mined form the rocks, consisting in amosite (brown asbestos), crocidolite (blue asbestos) and÷or chrysotile (white asbestos) used in many industries. Researches about the exposure to asbestos dust and asbestosis related diseases started almost a century ago. The first case report of fatal asbestosis disease was published in 1906, in England, by Dr. Hubert Montague Murray. A decade after, asbestos "curious bodies" were firstly described in the lung tissue by Cooke (1926) and McDonald (1927). Occupational exposure to asbestos is now regulated in Romania, but past exposure is still a cause of asbestosis-related diseases (ARDs), including lung cancer. A peculiar association between a lung adenocarcinoma, a previously healed pulmonary tuberculosis (PTB) disease, is reported in a 61-year-old nonsmoker white man, a former factory worker with 29 years of occupational exposure history to cement and asbestos fibers. The positive diagnosis of asbestos exposure was facilitated by asbestos bodies determined in bronchoalveolar lavage fluid. The main purpose of this case report is to describe the development of a right pleural effusion which was not revelatory for a mesothelioma but for an adenocarcinoma of the lung. An accurate morphologic and immunohistochemistry assessment of a pleural biopsy sample excluded mesothelioma and was crucial in the positive diagnosis of adenocarcinoma. In conclusion, unilateral paraneoplastic pleural effusion in a nonsmoker male with occupational exposure to asbestosis fibers was suggestive for adenocarcinoma related asbestosis of the lung. Lung cancer and malignant pleural exudate developed after a long latency cumulative retention time of asbestos fibers.
International Journal of Chronic Obstructive Pulmonary Disease, Sep 1, 2021
This study assessed the characteristics and the relationship between symptoms in any part of the ... more This study assessed the characteristics and the relationship between symptoms in any part of the 24-hour (24-h) day, physical activity level (PAL), and other clinical and functional outcomes in stable COPD patients. Patients and Methods: Out of the 2162 patients enrolled in the SPACE study (The Symptoms and Physical Activity in COPD patients in Europe, clinicaltrials.gov NCT03031769), 406 (18.8%) were recruited from Romania. Here, we present the Romanian cohort results. Eligible patients were adults with age at least 40 years, confirmed diagnosis of stable COPD, current or former smokers with a smoking history of minimum 10 pack-years. The 24-h respiratory symptoms were assessed using Early Morning Symptoms of COPD Instrument (EMSCI), Evaluating Respiratory Symptoms in COPD (E-RS™: COPD) and Nighttime Symptoms of COPD Instrument (NiSCI). During clinical interview, patients self-evaluated PAL through Exercise as Vital Sign (EVS) and Yale Physical Activity Survey (YPAS). Physicians assessed PAL through their clinical judgment. Results: For each combination of 2 between the early morning (EM), daytime (DT) and night-time (NT) symptoms of the 24-h day, there was a significant association (p < 0.001 for each). All symptoms significantly correlated with exacerbation history (p < 0.001 for EM and NT, p=0.002 for DT), and number of severe exacerbations (p < 0.001 for DT, p=0.001 for EM and p=0.026 for NT, respectively). The 24-h symptoms correlated negatively and significantly with PAL (p < 0.001), irrespective of the assessment used. Self-reported PAL negatively correlated with dyspnea, symptom burden, severity of disease and number of exacerbations (p < 0.001). Patients spent an average (standard deviation) of 25.8 (21.0) hours/week performing physical activity. Physicians overestimated their patients' daily PAL. Conclusion: A negative and significant correlation between the 24-h day symptoms and PAL was identified in stable COPD patients. Physicians need to routinely assess PAL using adequate tools and start educating inactive COPD patients to optimize their disease outcomes.
The serum enzymes are ideal diagnostic or prediction markers. Aspartate aminotransferase (AST), a... more The serum enzymes are ideal diagnostic or prediction markers. Aspartate aminotransferase (AST), a mitochondrial and cytoplasmic enzyme, is one of the well-known markers of hepatic, myocardial or skeletal muscle cytolysis, while alanine aminotransferase (ALT) is mainly a hepatic cytoplasmic enzyme. The normal plasmatic values of AST and of ALT reflect a physiological cell turnover. Therefore, both high and low levels of serum liver enzymes might have a clinical significance. We have conducted a retrospective study targeting the association between the serum AST and ALT levels and the lung function impairment among patients with occupational asthma but without hepatic, cardiac, renal or muscular disorders. Our data show a significant relation (R = 0.54, p <0.05) between the parameters of obstructive ventilator syndrome and AST and ALT levels, respectively (R =0.42, p <0.05). If this relation is confirmed in prospective studies, serum AST and ALT could become useful markers in monitoring asthma patients.
International Journal of Molecular Sciences, Aug 20, 2021
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Romanian Journal of Occupational Medicine, Aug 27, 2020
The definition of COVID-19 as occupational disease follows the investigation of any other occupat... more The definition of COVID-19 as occupational disease follows the investigation of any other occupational disease caused by an infectious agent. The risk is not equal for all occupations and the occupational physician has to assess the working conditions to conclude a diagnosis of occupational COVID-19. In the pandemic context, employees face also other occupational hazards. The high level of work load and the scarce resources lead to stress, physical and mental exhaustion and irregular sleep. The protection measures, of undisputable benefit, increase the risk for contact dermatitis. There is a high probability for medium and possible long term effects of COVID-19, such as the post-traumatic stress disorder or the respiratory sequelae. These consequences need to be acknowledged and properly manged by the medical team taking care of the patient. This review presents the main characteristics of the occupational related disorders during and after the current pandemia.
Respiratory symptoms significantly impact daily activities and quality of life of patients with c... more Respiratory symptoms significantly impact daily activities and quality of life of patients with chronic obstructive pulmonary disease (COPD). A multidimensional construct, physical activity emerged as an important functional outcome in COPD based on constant association with exacerbations and mortality. This study aimed to describe the prevalence and severity of respiratory symptoms, physical activity level and their relationship in stable COPD patients.
Alpha-1 antitrypsin deficiency (AATD) is an underdiagnosed genetic disorder that manifests primar... more Alpha-1 antitrypsin deficiency (AATD) is an underdiagnosed genetic disorder that manifests primarily through pulmonary and hepatic impairment. In Romania, a targeted detection program testing for AATD was implemented between October 2012 and October 2016. A cohort study enrolled all patients with indication for AATD screening (lung or liver disease, adults and children, index and non-index cases). Testing methods were mainly represented by isoelectric focusing, genotyping and/or sequencing. 620 patients (21 children) were tested (median age 50.0�16.4 years, 58.1% men), 91.9% of proved normal. A total of 50 patients were identified to be carrying a modified genotype (26 men). Hardy-Weinberg equilibrium was used for assessing the frequency of the genetic abnormalities: 1/1.08 PiMM, 1/32 PiMS, 1/28 PiMZ, 1/48 M-rare allele heterozygote, 1/3906 PiSS, 1/2770 PiZZ, 1/1000 PiSZ and 1/12346 for a Z-rare allele heterozygote. Severe AATD was present with a 1% frequency. Prevalence of abnormal...
ABSTRACT Abstract. Lung cancer in never-smokers is a common causes of morbidity and mortality. Th... more ABSTRACT Abstract. Lung cancer in never-smokers is a common causes of morbidity and mortality. The aim of the research was to summarise the impact of environmental risk factors on the occurrence of lung cancer in never-smokers. For this purpose, a prevalence study was conducted from 01.01.2008 to 31.12.2011, in non-smokers adults diagnosed with lung cancer. After inform consented, a simplified screening questionnaire based on demographic data, smoking, indoor and environmental air pollutants, including radon, occupational exposure and medical history was applied. Study population consists in 100 never-smokers mean aged 54.04-year old, with a male preponderence (54%), and urban residence (31%). There were identified exposure to radon gas inside buildings near uranium mines of the Stei- Baita area (19%); indoor air pollution from solid fuels, oil vapours and smoke, coal smoke (5%); work-related exposure to asbestos and coal dust, carbon ash, silica, glass fibres, metals, vapour of chemical pollutants, or fumes of polymers (23%), agricultural pesticide (8%) and, most of all, second-hand tobacco smoking (67%). Tuberculosis and CO PD were related with adenocarcinoma, respectively epidermoid carcinoma. Environmental air pollutants could be implicated in the etiology of lung cancer, but more than a half of participants had also second-hand smoking exposure. Keywords: lung cancer, never-smokers, environmental pollutants, radon, second-hand smoking.
PURPOSE: Our study tries to estimate the influence of smoking on serum levels of thyroid hormones... more PURPOSE: Our study tries to estimate the influence of smoking on serum levels of thyroid hormones, antithyroid peroxidase and antithyroglobulin antibodies among women with various clinical forms of chronic autoimmune thyroiditis.
INTRODUCTION: To reveal the risk of pulmonary hamartoma mimicking pulmonary tuberculoma. To explo... more INTRODUCTION: To reveal the risk of pulmonary hamartoma mimicking pulmonary tuberculoma. To explore the varied and unusual, clinical and radiological pattern of pulmonary hamartoma.
The objective was to compare the improvement of quality of life (QoL) between smokers with chroni... more The objective was to compare the improvement of quality of life (QoL) between smokers with chronic obstructive pulmonary disease (COPD) who completed a PR program complementary of the smoking cessation treatment and those who received usual treatment. Methods: Inclusion criteria were: evidence of COPD according to GOLD standards; an initial HbCO > 2% and an initial COPD Assessment Test (CAT) completed by every patient. From 437 smokers with COPD (GOLD stages II-III) only 113 pacients were enrolled in a 12 weeks supervised PR program, complementary the smoking cessation treatment (the PR group), and 324 smokers received the treatment for COPD and for stop smoking, monitorized as well for 12 weeks (non-PR group). All pacients completed the CAT questionnaire at the beginning and at the end of the determined period. Results: Initially, CAT scores varied between 26-38 without any diferrence between the PR group and the other patients. At the end of the period, the CAT scores in the PR group were between 7-16 comparing to the non-PR group where CAT scores shown little improvements since the beginning of the treatment, with values between 20-26, additionally to smoking cessation failure at an important number of non-PR members (45.98%) than the PR group (16.81%). There were reported as well higher rates of long-term abstinence in the pacients adherent to PR than the other group. Conclusions: Although current smokers are often expected to have a small PR adherence, COPD smokers who completed the PR presented important QoL improvements, better CAT score than COPD smokers usually treated. Moreover, a better PR adherence seems to be related with higher rates of sustained long term abstinence.
Background. Rheumatoid arthritis (RA) is a systemic inflammatory disease, associated with a numbe... more Background. Rheumatoid arthritis (RA) is a systemic inflammatory disease, associated with a number of extra-articular organ manifestations. Pulmonary involvement is a frequent and severe extraarticular manifestations of rheumatoid arthritis. RA can affect lung parenchyma, airways and pleura. Objectives. To identify RA-related lung disease on chest computed tomography (CT). Material and methods. We performed high-resolution computed tomography (HRCT) on a total of 92 patients with longstanding RA. Results. The subjects were predominantely female (79.3%), the age at entry was 63.77 ±11.56 years, and 42.9% had a history of smoking. Disease duration was 15.00±11.55 years. Pulmonary CT abnormalities were found in 71 of the 92 patients (77.2%). The most common HRCT anomalies were: linear attenuation (reticulation) (52.11%), bronchiectasis andbronchial wall thickening (45%), nodular attenuation (39.43%) and pleural involvement (pleural effusion or thickening) (39.43%). Conclusions. We conclude that RA-related lung disease was commonly detected on chest CT imaging in longstanding RA patients.
Sleep apnea episodes represent a problem both for the patients and for the patient's bed partners... more Sleep apnea episodes represent a problem both for the patients and for the patient's bed partners. The objective of this study was to record the comparative effects of two types of polymeric appliances in the therapy of some mild apnea symptoms (bruxism and snoring). The effect of therapy with the used appliances was pursued on 42 patients, divided in two groups. In the first group of 21 patients, we used a custom made appliance achieved by Erkoflex disks, and in the second group of 21 patients, the preformed SomnoFit®-Oscimed polymeric appliance. The survey lasted for a 12 month period, 1 month before the insertion in mouth of the appliances and 11 months therapy with polymeric appliances. The authors' questionnaire was completed daily by the patients and their bed partners, which noted the night comfort with inserted appliances in the mouth, the existence/absence of morning pain in the area of the masseter muscle, existence/absence of the morning fatigue, respectively the maintaining, diminishing and the absence of snoring and of nocturnal bruxism. The results of the study were favorable and proved that the nocturnal therapy of bruxism and of snoring, by using these two polymeric appliances were efficient. SomnoFit® appliance performed better in reducing bruxism and snoring, but custom made Erkoflex appliances presented a greater resistance in time.
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