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Nebunoiu A.-M.,Marius Nasta Pneumology Institute | Nebunoiu A.-M.,Carol Davila University of Medicine and Pharmacy | Deleanu O.C.,Marius Nasta Pneumology Institute | Deleanu O.C.,Carol Davila University of Medicine and Pharmacy | And 7 more authors.
Pneumologia | Year: 2014

Alpha-1 antitrypsin deficiency is one of the genetic diseases with a clear impact on the structure and function of the lung, rarely diagnosed and treated. We present the case of a 51-year-old female patient, heavy smoker, known with chronic obstructive pulmonary disease (COPD) for 12 years, untreated, who was hospitalized for the first time in our clinic having symptoms of a severe COPD exacerbation. She has significant cardiac disease (rheumatic mitral disease, with previous episodes of pulmonary edema and cardiac arrest) and hepatitis B. The patient is hypoxic, with severe mixed ventilatory dysfunction. During the hospitalisation she received treatment of the exacerbation and after that she received recommendation of chronic inhaled bronchodilator and corticosteroid treatment. The test for alpha-1 antitrypsin deficiency has detected a plasma of 63 mg/dl, SZ phenotype. The patient returns for a second evaluation. Functional tests are significantly improved (despite inconsistent treatment) with the impressive improvement of FEV1 values and identification by plethysmography of a restrictive syndrome. Echocardiography identifies mitral valve changes likely rheumatic, severe pulmonary hypertension. Computer tomography was performed, highlighting discrete interstitial changes and denying the existence of emphysema. Marked increase in FEV1 values supported adding bronchial asthma to the list of diagnosis and recommendation to continue inhaled corticosteroid combination bronchodilator as treatment. The particularity of the case is the rare phenotype, association of asthma and COPD as the clinical manifestation and the presence of comorbidities, which complicates the diagnosis and prognosis.


Constantin B.,Grigore T. Popa University of Medicine and Pharmacy | Postolache P.,Grigore T. Popa University of Medicine and Pharmacy | Croitoru A.,Marius Nasta Pneumology Institute | Nemes R.-M.,Marius Nasta Pneumology Institute
Journal of Environmental Protection and Ecology | Year: 2015

Occupational asthma (OA) is caused by different substances from the professional practice. The misdiagnosis and errors appear frequently. In order to establish correctly the incidence and prevalence of OA is necessary the examination of a multidisciplinary team. The aim of the study was the evaluation of asthma prevalence among occupational respiratory diseases (RD), defned by its clinical aspects. To evaluate the hospitalised asthma in an occupational diseases clinic (ODC) was made a 5-year study, among 395 inpatients, mean aged 41-year old, by the pattern of profession and workplace, exposure time, frst and fnal diagnosis, evolution. The prevalence of hospitalised morbidity by RD was 80%, of which 12% asthma. Among 395 cases with hospitalised asthma, 291 (74%) were OA and 104 (26%) asthma related profession, having a mean exposure of 26 years. Three quarters (77%) came from the environment with exposure to vegetal dust, of which the textile had priority (48%), followed by grain dust (17%) and wood (12%); 23% came from sectors with exposure to chemical powder, with irrelative OA. More than a half of patients (n = 156/291; 53%) were admitted in the ODC with misdiagnosis of occupational diseases. The results emphasised the frequent misdiagnosis errors by non-knowledge, ignorance, under or over estimation of occupational exposure, having ill-fated consequences for inpatients. A partnership collaboration and interdisciplinary team work may have an impact on preventing and diagnosing properly OA.


Postolache P.,Grigore T. Popa University of Medicine and Pharmacy | Nemes R.-M.,Marius Nasta Pneumology Institute | Croitoru A.,Marius Nasta Pneumology Institute | Constantin B.,Grigore T. Popa University of Medicine and Pharmacy
Journal of Environmental Protection and Ecology | Year: 2015

Pulmonary rehabilitation (PR) is an useful tool in the management of the respiratory diseases, especially in Chronic Obstructive Pulmonary Disease (COPD). The aim of the study was to assess the results of a PR program on dyspnea, exercise tolerance and quality of life (QoL) in patients with occupational COPD. For this purpose, 25 patients with stable occupational COPD stages II-IV GOLD (2011), mean age 60.4 years-old, 20 men/5 women (ratio 5:1), non-smokers, with history of exposure to respiratory hazards (fumes, dusts, chemical substances), 3 patients still professionally active; the mean body mass index (BMI) was 27.1 kg/m2 and the mean forced expiratory volume in 1 (FEV1) value - 42.4% of predicted. PR multidisciplinary program has consisted in exercise training, respiratory therapy and therapeutic education. Dyspnea (mMRC scale), exercise tolerance (6 min walking test), QoL (St George Respiratory Questionnaire SGRQ) were evaluated. After ending the PR program, dyspnea decreased with 1.06 points on mMRC scale, 6 min walking distance increased with a mean of 56.05 m, SGRQ score decreased with 5.2 points (statistically signifcant). Our PR program was effective resulting in improvement of symptoms, exercise tolerance and QoL. PR is a therapeutic tool that can be successfully used in patients suffering from occupational lung disease.


Rascu A.,Stefan Cel Mare University of Suceava | Moise L.,Stefan Cel Mare University of Suceava | Naghi E.,Stefan Cel Mare University of Suceava | Deleanu O.C.,Marius Nasta Pneumology Institute | Arghir O.C.,Clinical Pneumophtisiology Hospital
Journal of Environmental Protection and Ecology | Year: 2015

Sick building syndrome (SBS) is a healthy concern but a poorly understood phenomenon. Since the 1970s, researchers have tried to define what causes Sick building syndrome, but no single cause has been identified. Most experts believe that SBS consists in a mixture of different risk factors related to working stress, caused by an adverse indoor environment. Workers in the same building environment may react differently. Some may have acute different nonspecific symptoms caused by working such as headaches, dizziness, nausea, aches, pains, fatigue, poor concentration, shortness of breath or chest tightness, others may develop allergic rhinitis, skin irritation, irritation of mucous membranes. Symptoms related to the building, as a workplace, have no other identifiable cause of disease, may vary day by day and usually disappear if the working conditions are improving, or if the person leaves the building. The purpose of this case report is to present later diagnosis of SBS in a young nonsmoker male exposed to an unhealthy indoor environment. SBS is considered a real challenge for all physicians and especially for the occupational health doctors. A number of measures must be taken at workplace in order to help preventing the symptoms of this syndrome.


Todea D.A.,University of Medicine and Pharmacy, Cluj-Napoca | Rosca L.E.,University of Medicine and Pharmacy, Cluj-Napoca | Postolache P.,Grigore T. Popa University of Medicine and Pharmacy | Coman A.-C.,University of Medicine and Pharmacy, Cluj-Napoca | Nemes R.-M.,Marius Nasta Pneumology Institute
2013 E-Health and Bioengineering Conference, EHB 2013 | Year: 2013

Patients with acromegaly are reported to have a 1.6 to 3.3 fold increase in the mortality rate and a 10-year reduction in their lifespan. Sleep apnea is considered the most common respiratory complication in acromegaly. The aim of our study was to evaluate the severity of sleep apnea, and its particularities, in patients with acromegaly in Cluj-Napoca, Romania. We investigated 35 patients with acromegaly, referred to our Hospital for nocturnal sleep study investigations. Obstructive sleep apnea syndrome has a higher frequency in acromegalic patients. Sleep apnea symptoms were more frequent in women; severity was correlated with age, Epworth Scale, heart rate and with mean nocturnal oxigen saturation, diabetes mellitus. Comorbidities are common both in sleep apnea syndome and in acromegaly, contributing to a higher mortality rate. Therefore, sleep studies are mandatory for all patients with acromegaly and obstructive sleep apnea syndrome. © 2013 IEEE.


Todea D.-A.,University of Medicine and Pharmacy, Cluj-Napoca | Rosca L.-E.,University of Medicine and Pharmacy, Cluj-Napoca | Postolache P.,Grigore T. Popa University of Medicine and Pharmacy | Coman A.-C.,University of Medicine and Pharmacy, Cluj-Napoca | Nemes R.-M.,Marius Nasta Pneumology Institute
2013 E-Health and Bioengineering Conference, EHB 2013 | Year: 2013

Patients with acromegaly are reported to have a 1.6 to 3.3 fold increase in the mortality rate and a 10-year reduction in their lifespan. Sleep apnea is considered the most common respiratory complication in acromegaly. The aim of our study was to evaluate the severity of sleep apnea, and its particularities, in patients with acromegaly in Cluj-Napoca, Romania. We investigated 35 patients with acromegaly, referred to our Hospital for nocturnal sleep study investigations. Obstructive sleep apnea syndrome has a higher frequency in acromegalic patients. Sleep apnea symptoms were more frequent in women; severity was correlated with age, Epworth Scale, heart rate and with mean nocturnal oxigen saturation, diabetes mellitus. Comorbidities are common both in sleep apnea syndome and in acromegaly, contributing to a higher mortality rate. Therefore, sleep studies are mandatory for all patients with acromegaly and obstructive sleep apnea syndrome. © 2013 IEEE.


Berlic C.,University of Bucharest | Barna V.,University of Bucharest | Manolescu B.,University of Bucharest | Mahler B.,University of Bucharest | And 2 more authors.
Digest Journal of Nanomaterials and Biostructures | Year: 2014

By means of Monte Carlo simulations, we investigated the nucleation of polymers in frustrated spaces, i.e. in spaces where one dimension is much smaller (or larger) than other (or others). The obtained results were compared with those predicted by the Avrami equation. In the case of the spontaneous nucleation, we found similarities with respect to the ordinary crystallization case, but the Avrami index has smaller values. For instantaneous nucleation conditions, we observed to have two distinctive regimes: 3- dimensional crystallization at the beginning of the process, followed by a behavior which is similar with the one that occur in spaces with low dimensionalities.

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