ABSTRACT
Air pollution is a serious problem in Romania, with the country ranking 13th among the most polluted countries in Europe in the 2021 World Air Quality Report. Despite the recognized impact of pollutants on health, there has been a lack of large-scale studies conducted in Romania. This study investigated the impact of air pollutants on patients with chronic respiratory, cardiovascular, cerebrovascular, or metabolic diseases in Bucharest and its metropolitan area from 20 August 2018 to 1 June 2022. The daily limit values for particulate matter PM10 and PM2.5 were exceeded every month, especially during the cold season, with a decrease during the COVID-19 pandemic restrictions. A significant statistical correlation was found between the monthly average values of PM2.5 and PM10 and hospitalizations for respiratory and cardiovascular diseases. A 10 µg/m3 increase in monthly average values resulted in a 40–60% increase in admissions for each type of pathology, translating to more than 2000 admissions for each pathology for the study period. This study highlights the urgent need for national and local measures to ensure a cleaner environment and enhance public health in Romania according to international regulations. © 2023 by the authors.
ABSTRACT
A 64-year-old never-smoker man, with professional exposure, presented to Marius Nasta Pneumophtisiology Institute for fatigability to effort, in the context of severe SARS-COV2 infection one month previously. His medical history includes pulmonary tuberculosis (55 years ago) and newly diagnosed type II diabetes (261 mg/dL glycemia). The thoracic tomography computer in the immediate post-COVID period (Fig. 1A) revealed the presence of glass ground lesions and a 3 cm nodule with cystic degeneration in the upper left lobe. A gross examination of the specimen identified a condensation area of 2.5 cm diameter, brown-grey colored, with necrosis and central ulceration. Microscopic examination showed the presence of bronchiectasis with squamous metaplasia of the epithelium, which appears ulcerated;numerous calcium oxalate crystals with adjacent foreign body granulomatous reaction;endobronchial are present fibrinous and inflammatory debris, brown-black pigment, and septate, dichotomous branching hyphae, suggestive of Aspergillus spp. A periodic acid-Schiff stain was performed, identifying the fungal hyphae. The histopathological diagnosis was bronchiectasis supra-infected and colonized with fungal filaments (Aspergillus niger).
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. © 2020 Ioana Munteanu et al., published by Sciendo 2020.
ABSTRACT
SARS-COV2 infection is a challenge for the clinician, not only in the acute phase, in which the impairment of the patient's respiratory function can occur and evolve surprisingly quickly, but also in the post-acute phase, when the patient, especially the one who needed support long-term ventilator, requires complex recovery of respiratory, motor, neurological and cardiac functions. We present the case of a 60-year-old patient, diagnosed with a severe form of SARS COV2 infection for which he needed ventilatory support for 20 days, as well as antiviral treatment, systemic corticosteroid, anticoagulant and antibiotic. After 20 days from the first positive RT-PCR test, the patient is considered cured in terms of SARS COV2 infection, but severe respiratory failure requires transfer to the Pulmonology Department of the Marius Nasta Institute for further treatment. Upon admission to the ward, the patient has hypotrophy and hypotonia in the limb muscles, resting dyspnea, bilaterally diminished vesicular murmur, bilateral subcrepitant rales, SaO2 = 72% in aa and rest, 90% with oxygen supplement 8/min. Starting with the 10th day of hospitalization respiratory physiotherapy is initiated. The rehabilitation of the patient is also supported through exercises for the upper limbs with dumbbells, walking with frame support and breathing exercises with incentive spirometers. After 30 days of systemic corticosteroid therapy, anticoagulant treatment and respiratory physiotherapy, the patient was able to make the daily activities, the spirometry reveals a moderate restrictive syndrom;after 60 days the respiratory function was normal. Conclusion: The management of patients after severe SARS-COV 2 infection in order to improve and maintain the quality of life requires a long time care and multidisciplinary team consisting in pulmonologist, respiratory therapist, nurse, cardiology specialist.