[Extreme solutions for those who do not succeed to quit smoking. About smokeless tobacco and harm reduction (part II)]. / Solutii extreme pentru cei ce nu reusesc sa renun e la fumat. Despre smokeless tobacco si harm reduction (Partea a II-a).

Although in the last two decades, intensified tobacco control measures have increased access to smoking cessation services worldwide and pharmacological therapy in the field had enlarged spectrum and has higher efficiency, yet, long term abstinence rate is no more than 20-25%. Only 70% of smokers are willing to quit and only 10% succeed for good. The rest of 60% plus 30% not even willing to quit will balance between new attempts to quit, new failures to quit and continuing smoking, mainly cigarettes. Among them, many heavy smokers, highly nicotine addicted, unable to quit, even if strongly motivated too. Harm reduction concept is proposing alternatives to classic cigarettes smoking, which is the most dangerous modality of tobacco products consumption. Such alternatives try to minimize as much as possible harm induced by tobacco smoking, by reducing carcinogenic and toxic compounds in tobacco products. Overview of smokeless tobacco types is given, with health risks and consumption particularities in each case. Scientific community in the field's opinions are presented from the perspective of finding ways to save as many lives as possible of smokers unable to quit and to change actual status quo. As part of experts predict continuous increasing smoking prevalence in the future unless competitive alternatives to cigarettes smoking are arising, such alternatives can be temporarily helpful, in order to assist all categories of smokers to avoid tobacco smoke (most dangerous form of smoking) exposure.

[Extreme solutions for those who do not succeed to quit smoking. About smokeless tobacco and harm reduction]. / Solutii extreme pentru cei ce nu reusesc sa renunte la fumat. Despre smokeless tobacco si harm reduction (partea I).

Although in the last two decades, intensified tobacco control measures have increased access to smoking cessation services worldwide and pharmacological therapy in the field had enlarged spectrum and has higher efficiency, yet, long term abstinence rate is no more than 20-25%. Only 70% of smokers are willing to quit and only 10% succeed for good. The rest of 60% plus 30% not even willing to quit will balance between new attempts to quit, new failures to quit and continuing smoking, mainly cigarettes. Among them, many heavy smokers, highly nicotine addicted, unable to quit, even if strongly motivated to. Harm reduction concept is proposing alternatives to classic cigarettes smoking, which is the most dangerous modality of tobacco products consumption. Such alternatives try to minimize as much as possible harm induced by tobacco smoking,by reducing carcinogenic and toxic compounds in tobacco products. Overview of smokeless tobacco types is given, with health risks and consumption particularities in each case. Scientific community in the field's opinions are presented from the perspective of finding ways to save as many lives as possible of smokers unable to quit and to change actual status quo. As part of experts predict continuous increasing smoking prevalence in the future unless competitive alternatives to cigarettes smoking are arising, such alternatives can be temporarily helpful, in order to assist all categories of smokers to avoid tobacco smoke (most dangerous form of smoking) exposure.

[Treatment of pulmonary hypertension in COPD: is there hope for the better?]. / Tratamentul hipertensiunii pulmonare (HTP) din BPOC: exista sperante reale de mai bine?

The aim of this study is to prove for a well tolerated medication (clinical and financial) a supplementary effect in improvement prognosis of patients with pulmonary hypertension secondary to COPD, already treated with classical pneumology drugs. Three pts. groups were selected: the first received only classical pneumology treatment, the second with supplementary therapy by IECA and Ca-blockers, the third with supplementary therapy with IECA and nebivolol; the follow-up protocol included clinical and paraclinical status (blood gases, spirometry, ECG, echocardiography, 6 minute walk test) over 3 months. Clinical and paraclinical evolution of the pts. in group 2 and group 3 was significantly better that in pts from group 1. We conclude that addition of IECA + Ca-blocker/IECA + nebivolol therapy at classical pneumology therapy result in a better evolution in pts. with pulmonary hypertension secondary to COPD.

[Thromboembolic chronic pulmonary hypertension--a fake primary pulmonary hypertension--case report]. / Hipertensiunea pulmonara cronica tromboembolica--o falsa hipertensiune pulmonara primara--caz clinic.

Chronic pulmonary hypertension (CPHT) is on the third place of causes leading to cardiovascular morbidity and mortality in patients over fifty. Two of the rare causes of CPHT (< or = 7%) are: chronic thromboembolic hypertension and primary one; these two diseases resemble in many situations and, consequently, the diagnosis is frequently difficult (especially when risk factors for recurrent pulmonary thromboembolism are not present). Our case presentation is just such a situation; only pulmonary perfusion scintigraphy allowed us to make the right diagnosis--chronic thromboembolic pulmonary hypertension--in an "apparently clear" primary pulmonary hypertension.