Pneumologia最新文献

{"title":"Synchronous primary lung cancer and controlateral pulmonary renal cell carcinoma metastases.","authors":"Ciprian Bolca,&nbsp;Diana Leonte,&nbsp;Mihai Radulescu,&nbsp;Ion Jentimir,&nbsp;Georgiana Fotache,&nbsp;Tudor Mateescu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Synchronous malignant lesions will always entail treatment related difficulties which would ideally require discussions within a multidisciplinary committee in such a way as to reach the optimal solution for the patient. Presented herewith are two patients suffering from lung cancer and clear cell renal carcinoma contralateral metastases and the treatment alternatives that I have opted for.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"64 2","pages":"41-3"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34122591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary hypoplasia with associated cardiac and skeletal malformations.","authors":"Efrén Martínez-Quintana,&nbsp;Fayna Rodríguez-González","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patients with mild pulmonary hypoplasia typically use to have minimal respiratory symptoms. Nonetheless, other associated anomalies such as cardiac, gastrointestinal, genitourinary, or skeletal defects may be seen. We report the case of a 17-year-old male patient with hypoplastic right lung with secondary cardiac dextroposition, an ostium secundum atrial septal defect, a hypoplastic right pulmonary artery arising from the posterior wall of the left pulmonary artery with a retrocava course, vertebral bone fusion and pollicization due to right congenital thumb absence.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"64 2","pages":"44-6"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34122592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Positive pressure therapy in patients with cardiac arrhythmias and obstructive sleep apnea.","authors":"Giorgiana Nicoleta Dediu,&nbsp;Stefan Dumitrache-Rujinski,&nbsp;Rizvan Lungu,&nbsp;Sabina Frunză,&nbsp;Camelia Diaconu,&nbsp;Daniela Bartoş,&nbsp;Miron Alexandru Bogdan","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Positive pressure therapy (CPAP) in patients with cardiac arrhythmias and obstructive sleep apnea (OSAS) may have favorable effects by correcting intermittent hypoxemia and sympathetic activation.</p><p><strong>Objective: </strong>To assess the effect of CPAP added to pharmacological treatment in the rate control and prevention of arrhythmias recurrence in patients with OSA.</p><p><strong>Materials and methods: </strong>Prospective, interventional study study which included patients diagnosed with OSAS (cardiorespiratorypolygraphy, AHI>5/hour), and arrhythmias (ECG, Holter ECG), divided in two groups: group A (pharmacological therapy only) and group B (pharmacological therapy and CPAP). The patients were evaluated at enrollment (T0), at 3 and 6 months (T3 and T6) regarding the type, severity and recurrence of cardiac arrhythmias.</p><p><strong>Results: </strong>36 patients (31 men), mean age: 63.2 ± 12 years were enroled. In group A: 7 patients with ventricular extrasystoles, 8 with permanent atrial fibrillation, 1 patient with atrial flutter and 2 patients with paroxystic supraventricular tachycardia. In group B: 8 patients with ventricular extrasystoles, 5 with permanent atrial fibrillation, 2 patients with recurrent episodes of atrial fibrillation and 3 with paroxystic supraventricular tachycardia. A positive correlation (r: 0.74, p < 0.001) between Oxygen Desaturation Index and AHI was found. At T6, 12 patients from group B, and 18 from group A were evaluated. In group B, the mean heart rate in patients with atrial fibrillation was 69/min., lower than in group A (82/min.), no cases with recurrent atrial fibrillation were found, and more patients with class II Lown ventricular extrasystoles passed in class I Lown, compared to group A. In group B, heart rate statistically correlated with AHI (r: 0.53, p < 0.005).</p><p><strong>Conclusion: </strong>In patients with OSAS, adding CPAP to pharmacological therapy has favorable effects on preventing recurrences, heart rate control in patients with atrial fibrillation and in reducing frequency and/or severity of ventricular extrasystoles.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"64 1","pages":"18-22"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33337625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary metastasectomy--general issues.","authors":"Ciprian Bolca,&nbsp;Ioan Jentimir,&nbsp;Georgiana Fotache,&nbsp;Tudor Mateescu,&nbsp;Cristian Paleru,&nbsp;Ioan Cordoş","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Pulmonary metastasectomy has been widely accepted by thoracic surgeons and is applied to the treatment of a variety of histologies, but the evidence that the patient may benefit from lung metastasectomy is not yet elucidated and the best way of integrating oncologic therapies (induction or adjuvant chemotherapy or radiotherapy) with surgical resection are still unknown. When there is no good clinical alternative, the resection of pulmonary metastases can give some patients long-lasting disease free intervals. Patients should be carefully selected on the basis of clinical staging with defined prognostic indicators. In order to obtain suitable results the management of these patients should be based on a multidisciplinary team decision.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"64 2","pages":"20-2"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34122586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nodular pulmonary amyloidosis--rare cause of calcified pulmonary nodules.","authors":"Anca Macri,&nbsp;Radu Matache,&nbsp;Diana Leonte,&nbsp;Radu Stoica","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The article presents the case of a 60-year-old asymptomatic woman whose chest X-ray screening showed bilateral pulmonary nodules of uncertain etiology. Initially, the main suspicion concerned multiple pulmonary metastases, but the anatomical pathology examination of two of the surgically removed lung nodules revealed a benign pattern--foreign body granulomatous reaction to cholesterol crystals. Patient follow-up with a repeat computed tomography one year later showed that some pulmonary nodules had slightly increased in number and size, so the diagnosis required re-evaluation. Congo red staining revealed a positive reaction in the amorphous material, pointing to a nodular form of pulmonary amyloidosis. This case attests to the wide range of investigations needed to examine multiple pulmonary nodules and to the great variety of possible diagnoses. Surgical biopsy, alongside histopathological examination and immunohistochemical tests of the lung are critical in establishing a positive diagnosis. Pulmonary amyloidosis requires additional investigations and long-term follow-up of the patient, as this condition is frequently associated with MALT (mucosa-associated lymphoid tissue) lymphoma or multiple myeloma.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"64 1","pages":"30-5"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33337626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neural respiratory drive measurement for COPD assessment and monitoring.","authors":"Adam James Garland,&nbsp;Akash Doshi,&nbsp;Victor Turcanu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Currently there is an unmet need for more objective assessments that could determine COPD severity. Ideally such objective assessments could also anticipate COPD exacerbations in order to decrease the need for repeated hospital admissions. In this review we outline how patients' neural respiratory drive (NRD) may be determined using the electromyography of the diaphragm as an objective measurement of COPD severity. Respiratory muscle NRD is indeed less influenced by patients' voluntary effort limitation than for example when testing for exercise tolerance in which case the patients themselves decide when to stop. Exercise tolerance tests are better correlated with muscle weakness rather than COPD severity per se. NRD would also be less dependent upon patients' subjective perception of the severity of their breathlessness. A key further advantage is that recent studies showed that the diaphragm electromyography measurements using electrodes placed on the skin are correlated with those obtained using specific electrodes, therefore this method is non-invasive and more acceptable for routine clinical practice. Thus, NRD measurements could be used in COPD in a similar way as electrocardiography is used to evaluate and monitor ischemic heart disease. NRD measurements could therefore complement more established instruments such as lung function tests, FEV1, exercise tolerance tests, the BODE index etc. in COPD. This could lead to better COPD management and reduce the acute exacerbations which are amongst the most common causes of repeated hospital admissions and consume significant resources.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"64 1","pages":"14-7"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33337624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Inspirom\"--overview of the relationship between the pulmonologist and the COPD patient in Romania.","authors":"Florin Mihălţan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The aim of the study was to provide an insight of the investigation related to multiple clinical and care problems encountered by COPD patients in relations with the practitioner. In a 6 month prospective observational study (sponsored by Servier Pharmaceutical Company), started in 2012 and completed in 2013, in out-patient settings, we involved 39 doctors (from different pneumology centers of the country) and assessed the involvement of both doctors and 1,131 patients in their observance of the therapeutic indications, as well as patients' compliance with the medical instructions, 2 months after the therapeutic indication. In this observational study we analyzed through the new GOLD classification the COPD patients at the time of recruitment until the next monitoring visit in two months. We applied for the first time this new GOLD classification for Romanian COPD patients as an overview in a period of follow-up. Results showed that at detection time, 56% patients had mild and moderate obstruction (stage 1-2 GOLD) and 44% patients are in old GOLD stage 3-4. When we used new GOLD classification, 46.4% patients are in GOLD C and D stages, with 35% having CAT over 20 and 25% an mMRC over 2. There findings can be alarm signals related to the large number of smokers, the lack of involvement of doctors in fighting tobacco consumption, and over-assessment of mild stages of the disease. All these elements can guide future prevention programs and actions of active screening for this disease.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"64 1","pages":"24-8"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33341098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smoke-free politics--lessons to learn for Romania.","authors":"Florin Mihălţan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Very recently ASH -Global Action for everyone's health 2014 published two lesson on the progress of smoke free regulations in two countries France and Uruguay with all the explanations and comments referring to the results, limits and benefits of different strategies. I am trying to see in comparison with this two examples what we have done and what is necessary to learn in the future for also having in Romania a strong free regulation for smoke free environment.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"64 2","pages":"48-51"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34124527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interstitial lung disease as first clinical manifestation within the antisynthetase syndrome--dermatomyositis.","authors":"Daniel Trăilă,&nbsp;Ovidiu Fira Mlădinescu,&nbsp;Cristian Oancea,&nbsp;Voicu Tudorache","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Diffuse interstitial pneumopathies within the diseases of the connective tissue are often a diagnosis challenge, sometimes being the initial or dominant manifestation of the underlying autoimmune disease. The case of a young man shall be presented with relatively quick dyspnoea which has appeared under the conditions of an efficient physical status and without any notable pathological history. The cause of the dyspnoea is found to be a interstitial lung disease with radiological and histopathological pattern of non-specific interstitial pneumonia. The disease screening system discovers Ac anti Ro-52 which commits research in the direction of an autoimmune disease, confirmed by highlighting Ac anti PL-7 as being an antisynthetase syndrome. Subgroup of idiopathic inflammatory myopathies, the antisynthetase syndrome is a rare chronic autoimmune disease, which is characterised by the presence of antibodies directed against aminoacyl-t-RNA-synthetases (family of intracytoplasmic enzymes with a vital role in the protein synthesis). Shortly after specifying the relevant immunological status, the consistent clinical expression with dermatomyositis is also configured. The treatment is commenced with systemic corticoid and azathioprine; despite the treatment we are witnessing a slowly progressive clinical and functional deterioration.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"64 2","pages":"37-40"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34122590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mediastinal fibrosis and Hodgkin lymphoma mimicking bronchiolitis obliterans organizing pneumonia.","authors":"Ramona Elena Nedelcu,&nbsp;Emese Kiss,&nbsp;Mircea Ciorba,&nbsp;Paul Galbenu,&nbsp;Ruxandra Ulmeanu","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Bronchiolitis obliterans organizing pneumonia (BOOP) represents a kaleidoscope of concepts and morphologies, often being confused with a series of conditions, among which the most feared are Hodgkin's lymphoma and bronchioloalveolar carcinoma. We shall present the case of a 56-year-old patient, diagnosed in August 2013 with a pulmonary tumour of the right upper lobe, which was CTstaged - T4N0M0 (IIIA), who underwent a video-assisted thoracotomy for histopathological confirmation. A mediastino-pulmonary formation had been detected intraoperatively and multiple biopsies had been collected. The information brought by the histopathological examination suggested the presence of 2 synchronous pathologies, namely: the mediastinal biopsy showed an advanced degree of dense, compact fibrosis and the pulmonary biopsy highlighted the presence of granulation tissue and Masson bodies in the distal airspace with destruction of vascular and alveolar structures, an aspect which was compatible with organizing pneumonia (BOOP). Once a diagnosis was established, an oral corticosteroid therapy was initiated (Prednisone 30 mg/day) over a period of one month, but the symptomatology of the patient worsened. A new thoracic CT carried out in November 2013 highlighted the progression and extension of the paramediastinal tumoral formation, exhibiting central necrosis and invading the mediastinal vessels, causing their compression (superior vena cava syndrome) associated with multiple mediastinal and hilar adenopathies. The non-favorable evolution and the extensive array of conditions that may mimic the BOOP histopathological pattern have been the key elements, which were the basis of our persistence in getting a real diagnosis. Therefore, in this respect, the biopsy parts performed by thoracotomy were sent for immunohistochemical testing. The CD30 and CD15 positive markers distinctive for Reed-Sternberg cells allowed the diagnosis of Hodgkin's lymphoma.</p>","PeriodicalId":20345,"journal":{"name":"Pneumologia","volume":"64 1","pages":"40-5"},"PeriodicalIF":0.0,"publicationDate":"2015-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33337474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}