[Chronic management of COPD--results of a questionnaire for COPD patients]. / Managementul cronic al BPOC--rezultatele unui chestionar aplicat pacientilor.

AIM: evaluation of real ambulatory treatment followed by COPD patients. Eighty COPD patients were prospectively interviewed: 1 in stage I, 11 in stage II, 36 in stage III and 32 in stage IV. They were asked what medication they use as chronic ambulatory treatment and on what duration through one year, how many periodic check-ups they make. Most used medication is: short acting beta-2-agonists (63 pts), inhaled corticosteroids (40 pts), aminophylline (37 pts), long-acting theophylline (36 pts), and fixed combinations steroid + long-acting beta-2-agonist (35 pts). Eighteen patients had chronic prednisone treatment and 12 antibiotic prophylactic treatment. Only 31 patients had an anti-flu vaccine. There are no significant differences between treatment in rural and urban patients. Most patients follow the treatment for only 6 months a year. CONCLUSIONS: real ambulatory treatment in COPD is generally insufficient as duration and therapeutic principles, associating low frequency of periodic check-ups and a high frequency of exacerbations.

[A case of tumor-like pulmonary sarcoidosis]. / Sarcoidoza pulmonara--forma pseudotumorala.

We present the case of a female patient age 32, with no medical history, presenting with chest pain and asthenia. Chest X-ray and CT scan revealed multiple nodular shadows in both lungs, suggesting lung metastasis. Bronchoscopy and broncho-alveolar lavage didn't reveal any malignant cells. Clinical examination and lab examinations didn't find any primitive extra-pulmonary tumor. Open lung biopsy was performed, revealing sarcoidosis. Patient received oral steroids, with significant radiologic improvement after only 1 month.

[Considerations about the efficiency of treatment regimens with fixed Rifampicin-Isoniazid combinations in pulmonary tuberculosis]. / Consideratii privind eficacitatea regimurilor terapeutice ce au în componenta combinatii fixe Rifampicina-Izoniazida în tratamentul tubeculozei pulmonare.

Here are presented the results of a prospective, randomized study regarding the efficiency of regimens with fixed drug combination Rifampicin-Isoniazide manufactured by Antibiotics S.A. of Iasi in comparison with single drugs routinely used in treatment of patients with pulmonary tuberculosis. Newly diagnosed (confirmed by smear and culture) pulmonary tuberculosis patients were selected, and those who accepted to be included in the study, were admitted to the National Institute of Pneumology "Marius Nasta" between August 2001 and September 2002. At the time of admission, they were randomized into two groups: 20 patients received fixed drug combination RMP300 HIN150, and 18 patients received RMP and HIN in single drug tablets (2 patients were excluded). The follow-up of the patients was for one year from the date of enclosure. The smear conversion rate was 83,3% for the patients using single drug tablets, and 70% for those using fixed drug combination, motivated with some more severe TB patterns. The success rate was 100% for all TB patients. Although the present study was done for few patients, we can say that it demonstrated the same efficiency of fixed drug combination produced in Romania, with the single drug tablets, and it suggests a better compliance to treatment with a lower price.

[Recurrent pleural effusion revealing a left atrial myxoma]. / Pleurezie recidivanta--manifestare revelatoare a mixomului atrial.

A 43 years old woman without any medical history was admitted 8 months before with a right pleural effusion, considered and treated as tuberculous pleurisy, with a good evolution. The recurrence of the right pleural effusion, the reappearance of chest pain, anxiety and nocturnal dyspnea elicited new investigations. The pleural fluid had a low protein content, pleural biopsy was irrelevant. CT scan, bronchoscopy and abdominal ultrasound were of no diagnostic value. Cardiac ultrasound revealed a large left atrial tumor, determining mitral stenosis. The patient underwent surgery, the tumor was excised, the histologic type was myxoma. Three weeks after surgery a right pleural effusion was noticed, this time with high protein content and resolving with non-steroid anti-inflammatory treatment. Pleural effusion never reappeared in the following 6 months. Discussions are made upon the mechanism which determined the pleural effusion in this case.