Clinical challenges of SARS-CoV-2 variants (Review).

Since the first cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there have been challenges recognizing the clinical features of SARS-CoV-2 and identifying therapeutic options. This has been compounded by viral mutations that affect clinical response and primary epidemiological indicators. Multiple variants of SARS-CoV-2 have been identified and classified on the basis of nomenclature implemented by scientific organizations and the World Health Organisation (WHO). A total of five variants of concern (VOCs) have been identified to date. The present study aimed to analyse clinical and epidemiological features of each variant. Based on these characteristics, predictions were made about potential future evolution. Considering the time and location of SARS-CoV-2 VOC emergence, it was hypothesised that mutations were not due to pressure caused by the vaccines introduced in December 2020 but were dependent on natural characteristics of the virus. In the process of adapting to the human body, SARS-CoV-2 is expected to undergo evolution to become more contagious but less deadly. SARS-CoV-2 was hypothesized to continue spread through isolated epidemic outbreaks due to the unimmunized population, mostly unvaccinated children and adults, and for coronaviruses to continue to present a public health problem.

A Case of Unilateral Hyperlucency of the Lung: a Rare Adult Occurrence of Swyer-James-MacLeod Syndrome.

Swyer-James-MacLeod syndrome is a rare pulmonary disorder that exhibits unilateral hyperlucency of a part of or the entire lung and because it is usually asimptomatic the diagnostic of this illness is discovered accidentally after a chest X-ray. Although the cause of this disorder is not completely understood, most authors believe that this is due to late sequela of infectious bronchiolitis that occurs during childhood. The symptoms presented by the individuals are often scarce at the moment of diagnostic, but a history of recurrent episodes of pulmonary infection accompanied by dyspnea, hemoptysis and/or chronic productive cough should raise the suspicion for such a diagnosis. Swyer-James-MacLeod syndrome can be interpreted as asthma or pulmonary embolism and this can result in inappropriate therapy. This case report describes a 38-year-old patient with chronic respiratory symptoms diagnosed on the findings of the chest X-ray and high resolution CT.

Bronchiectasis in cystic fibrosis and pregnancy.

Cystic fibrosis is an autosomal recessive disease with a prognosis determined by the extent of pulmonary lesions. Here we present a rare case of a patient diagnosed with cystic fibrosis in the pediatric service, but who came for the first time to the Pneumology Hospital of Iasi. Respiratory failure, recurrent pulmonary infections and associated metabolic modifications generate a high vital risk during pregnancy.

Respiratory rehabilitation in healing depression and anxiety in COPD patients.

UNLABELLED: Chronic Obstructive Pulmonary Disease (COPD) is an inflammatory affection of the whole lung, characterized by an accelerated loss of the pulmonary functions, that reduces the patients' independence and stops them from having a normal, active life. The medical rehabilitation is considered "Third class rehabilitation", after preventive medicine and pharmaceutical medicine, and the respiratory rehabilitation recovery represents a complex structure of service addressing to patients with chronic pulmonary illnesses whose aim is to optimize the physical performances, psycho-social and autonomy. AIM AND OBJECTIVES: The main objective of this study is to show the importance of respiratory rehabilitation that is correctly and timely made, based on the gravity and stage of the illness, the COPD patient's associated illnesses and their importance in improving the patient's mental and physical quality of life. Patients from the study were assigned a complex pulmonary rehabilitation regimen consisting of 10 physical exercise sessions and 10 educational sessions, for two weeks, followed by 3 physical education sessions and medical education per week, for six weeks. MATERIAL AND METHOD; The research included 35 COPD patients from the 5th medical Geriatric and Gerontology. Clinic during 1.03.2014-30.11.2014. Patients from the study were assigned a complex pulmonary rehabilitation regimen consisting of 10 physical exercise sessions and 10 educational session for two weeks, followed by 3 sessions a week for 6 weeks. The dyspnea evaluation was made by BORG and MRC dyspnea scales, the quality of life was measured by St. George and CAT questionnaires, and anxiety and anxiety and depression were quantified by Hamilton Anxiety Rating Scale (HARS) and Hamilton Depression Rating Scale (HDRS). RESULTS: The gradation of dyspnea on BORG scale was correlated with the variation of the expiratory capacity that varied at COPD patients, suggesting that hyperinflation has a major role in producing the dyspnea. The average score measurement was about 75.25 ± 5.9. the positive effects of rehab were validated by decreasing the St. George score by 16% to the initial value. Respiratory rehab was an important way of treatment due to effort tolerance increasing and the patient's independence. Depression was significantly more pronounced in women (Z = -1.876: p = 0.039). The little value of maximum respiratory volume per second (VEMS) was correlated to a bigger HARS and HDRS score. CONCLUSIONS: The prevalence and importance of symptoms of anxiety and depression in COPD patients requires a specific questionnaire as routine screening procedure, for detecting early symptoms and preventing their progress.

[Non-cystic bronchiectasis: pathogenic correlations between the parameters of body composition, systemic inflammation and respiratory function]. / Bronsiectazii non-chistice: corelatii patologice intre parametrii compozitiei corporale, sindromul inflamator sistemic cronic si functia respiratorie.

UNLABELLED: The causes of bronchiectasis may be idiopathic or secondary to pulmonary diseases. The consequences determined by this pathology are found on different levels. AIM: To determine the relationships between the parameters of body mass composition, chronic systemic inflammatory syndrome and lung function inpatients with bronchiectasis. METHOD: 35 patients with bronchiectasis diagnosed through HRCT (High Resolution Computer Tomography) and 35 patients with COPD were enrolled in the study. The protocol included the testing of all subjects, not in an acute period, to determine body mass composition, lung function and systemic inflammation. RESULTS: Modified parameters of body mass composition significantly correlated with those determined by the presence of inflammatory syndrome and alteration of lung function mainly for patients with bronchiectasis compared with patients with COPD. CONCLUSIONS: There is an important relationship between the parameters that were studied and this call for an individualized and targeted treatment that will lead to significant improvement of the general status of patients with bronchiectasis.

Chronic venous insufficiency stage v ceap secondary to hereditary thrombophilia at a young man.

Hereditary thrombophilia is a rare disease of general population, which is responsible for debilitating consequences in severe cases. We present the case of a young male patient whose pathology and symptoms occurred since the age of two, which determined a venous insufficiency stage V with important limitation of the locomotors ability and plenty of complications. The aim of this paper is to draw attention to a disease that sometimes is not diagnosed on a first visit to the doctor.

[Pathophysiology and treatment of bronchectasis]. / Aspecte fiziopatologice si tratamentul in bronsiectazii.

Bronchiectasis is a complex pathology which consists of some important morphopathological changes in the lumen of the bronchi that consecutively determines recurrent pulmonary infections with a diversity of germs. The repeated episodes of infection are associated with chronic colonization of the respiratory system with certain pathogen microorganisms and play an important role in the maintenance of the chronic inflammatory syndrome, as well as the decline of the pulmonary function. This chronic inflammation is represented by a series of fisiopathological changes (the raised number of neutrophiles, macrophages, alteration in the expression of pro-inflammatory cytokine and adhesion molecules). The first hand treatment of patients with infected bronchiectas is the antibiotic treatment, followed by anti-inflammatory treatment and adjuvant therapy. The use of macrolides in the long-term treatment schemes has confirmed their role in the reduction of the chronic inflammatory syndrome associated with this disease, moreover its association with the anti-inflammatory medication has significantly improve the patient's health status.