Milena Adina Man

Iuliu Hațieganu University of Medicine and Pharmacy

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Nicoleta Ștefania Motoc

Iuliu Hațieganu University of Medicine and Pharmacy

Carmen Monica Pop

Iuliu Hațieganu University of Medicine and Pharmacy

Ruxandra Râjnoveanu

Iuliu Hațieganu University of Medicine and Pharmacy

Antigona Trofor

Clinica de Pneumologie Iaşi

Doina Adina Todea

Iuliu Hațieganu University of Medicine and Pharmacy

Monica Pop

Iuliu Hațieganu University of Medicine and Pharmacy

Bianca Domokos Hancu

Iuliu Hațieganu University of Medicine and Pharmacy

Elena Danteș

Ovidius University

Cosmina Ioana Bondor

Iuliu Hațieganu University of Medicine and Pharmacy

Ana Florica Chiş

Iuliu Hațieganu University of Medicine and Pharmacy

Cooperative Institutions

Iuliu Hațieganu University of Medicine and Pharmacy

129

Clinical Emergency Hospital Bucharest

Clinica de Pneumologie Iaşi

Grigore T. Popa University of Medicine and Pharmacy

Carol Davila University of Medicine and Pharmacy

University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca

Spitalul Clinic Județean de Urgență Cluj-Napoca

Ovidius University

Victor Babeș University of Medicine and Pharmacy Timișoara

Institute of Oncology Prof. Dr. Ion Chiricuta

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Parental environmental tobacco smoking and the prevalence of respiratory diseases in primary school children.

PubMed (2013)

Oana Cristina Arghir Elena Danteș Ramona Mihaela Stoicescu Irina Baicu Stela Halichidis

The inhaling tobacco smoke to which a child is exposed, in a home environmental area, could affect respiratory system.The aim of the study consists in detecting the prevalence of respiratory diseases in home exposure to secondhand smoke among primary school children. A 6-month prospective case-control study based on questionnaire survey was carried out among school children of "Spiru Haret" Primary School, Medgidia, Romania, with absences for respiratory diseases, related to exposure to parental passive smoking, in their home environmental. 136 school children and their families informed, consented to complete the questionnaire and were surveyed for respiratory diseases and domestic environmental tobacco smoking, from the 1st of October, 2011 to the 31st March, 2012. The method consists in collecting data about any respiratory illness events, correlating them with the questionnaire --reports of parental smoking in home environmental.Participants were divided in 88 cases exposed to SHS (E) and 48 controls without exposure (NE). The most sick children with more than one episode of respiratory illness were among cases (n = 61/88; 69.31% vs 19/48; 39.58%; OR = 3.45; RR = 1.62; chi2 = 12.25; p < 0.0008). The most important source of parental passive smoking is the father (n = 67/88; 76.13%), being a single parent in most of the cases (n = 46/88; 57.95%). The prevalence of bronchial asthma was 0.34% in cases, being related with prenatal maternal smoking exposure (1.11%).The prevalence of respiratory diseases is higher among children with environmental parental tobacco exposure, in particular, smoking father.

Tobacco smoke

Passive smoking

Respiratory illness

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Vascular risk factors in women with hypertension and diabetes mellitus type 2

Adriana Albu Daniela Fodor Cosmina Ioana Bondor Milena Adina Man

Background. Diabetes mellitus and arterial hypertension are two very frequent diseases. Both of them have important effects on vascular system and their major complications are caused by alterations of vasculature. Arterial hypertension and type 2 diabetes are frequently associated. Beyond classical risk factors implicated in both diseases, in recent years some novel markers of vascular involvement have been studied, such as intima – media thickness (IMT) and parameters of arterial stiffness. Women seem to have an increased vascular risk associated with diabetes than do men but this is not clean from the current literature. The aim of our study was to determine the consequences of hypertension and of hypertension associated with diabetes on intima media thickness and arterial stiffness in women. Patients and methods. We studied 30 women with hypertension (group 1), 33 with diabetes mellitus and hypertension (group 2) and 21 healthy controls (HC), matched for age. We evaluated some classical risk factors for atherosclerosis, such as age, body mass index, smoking, lipid and glucose profile in all patients and controls. We determined IMT of the common carotid artery using an ultrasound device (ALOKA prosound ɑ10) and parameters of aortic stiffness – pulse wave velocity (PWV) and augmentation index (Aix) in all patients and controls using an oscillometric device, Arteriograph (Tensio Med Ltd., Budapest, Hungary). We also determined with the same device central aortic systolic blood pressure (SBPao) and aortic pulse pressure (PPao). We compared data obtained between the three different groups examined. Results. We found that PWV was increased in group 1 patients compared HC (p<0.05) but those from group 2 had even higher values of PWV compared to HC (p=0.001). IMT was increased in patients from group 1 compared with HC and diabetic patients had a supplementary increase of this parameter compared with hypertensive patients but the values were significantly higher only when compared to controls. From the classical risk factors, BMI and also fasting plasma glucose were significantly higher in diabetic patients. Parameters of arterial stiffness were correlated with age. IMT was correlated with age, fasting plasma glucose, values of brachial systolic, diastolic and mean pressure and with aortic systolic blood pressure. IMT was also correlated with parameters of arterial stiffness, PWV and AIx. Conclusion. Women with hypertension had increased arterial stiffness compared to controls. Those with hypertension and diabetes had more increased arterial stiffness and also increased IMT compared to hypertensive women and to HC. In our patients age was an important determinant of parameters of arterial stiffness. IMT was correlated with age, values of peripheral and central arterial pressure and with parameters of arterial stiffness. Coexistent diabetes and hypertension in women is associated with increased markers of vascular disease that may be a link to the important cardiovascular risk seen in these patients.

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Intima-media thickness

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Smoking cessation for free: outcomes of a study of three Romanian clinics

Open Medicine (2016)

Antigona Trofor Milena Adina Man Corina Mărginean Dumitru Filipeanu Antigona Trofor

In 2007, Romania implemented a national program for smoking cessation, providing medication and counseling, entirely for free. The present study focuses on the results of the program among participating smokers treated in three smoking cessation centers from three main cities of Romania: Iasi, Targu Mures and Cluj. Telephone interviews of 832 subjects from three databases of the Romanian cessation clinics of Iasi, Cluj and Targu Mures cities were conducted. These interviews were based on a standard Romanian guideline follow-up questionnaire. At 3 months follow up, abstinence was quite high (53.4%); at 12 months post quit date the study found 18.6% still abstinent subjects. More severely addicted smokers have quit with varenicline and the most difficult category of patients was represented by heavy smokers with respiratory co-morbidities. 61.5% of smokers and 97.2% of non-smokers were willing to receive relapse prevention counseling. Many subjects achieved a long duration partial abstinence (154 days ± 180 SD abstinence days). This is the first study in Romanian smoking cessation centers to analyze the long term impact of fully reimbursed smoking cessation, covering three months pharmacotherapy and counseling. Providing smoking cessation for free had a positive long term impact on program participants.

Varenicline

Guideline

Romanian

Nicotine replacement therapy

Pharmacotherapy

10.1515/med-2016-0098

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Disease perception and coping with emotional distress during COVID-19 pandemic

Authorea (Authorea) (2020)

Milena Adina Man Claudia Toma Nicoleta Ștefania Motoc Viana Necrelescu Cosmina Ioana Bondor

Background: The novel coronavirus disease, COVID 19, is a highly contagious infectious disease declared by the World Health Organization pandemic and a global public health emergency. During outbreaks, health care workers are submitted to enormous emotional burden as they must balance the fundamental "duty to treat" with the parallel duty to family and loved ones. The aims of our study is to evaluate disease perceptions, levels of stress, emotional distress, and coping strategies among medical staff (COVID 19 versus non-COVID 19 department) in tertiary pulmonology teaching hospital in the first month after the outbreak of COVID 19. Methods: One hundred fifteen health care workers completed four validated questionnaires (the brief illness perception questionnaire, perceived stress scale, the profile of emotional distress emotional, cognitive coping evaluation questionnaire) that were afterward interpreted by one psychologist. Results: There was a high level of stress and psychological distress among health care workers in the first month after the pandemic outbreak. Interestingly, there was no difference between persons that work on COVID 19 department versus those working in non-COVID 19 department. Disease perceptions and coping mechanism were similar in the two groups. As coping mechanism, refocusing on planning and positive reappraisal were used more than in general population. Conclusions: there is no difference in disease perceptions, levels of stress, emotional distress, and coping strategies in medical staff handling COVID 19 patients versus personal that does not handle COVID patients the first month after the pandemic outbreak

Pandemic

10.22541/au.159242059.92923486

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Pulmonologists Adherence to the Chronic Obstructive Pulmonary Disease GOLD Guidelines: A Goal to Improve

Medicina (2020)

Ruxandra Râjnoveanu Armand Râjnoveanu Andreea-Bianca Ardelean Doina Adina Todea Carmen-Monica Pop

Background and objectives: Data about pulmonologist adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines showed a great variability and cannot be extrapolated. The present study investigates the current pharmacological prescribing practices in the treatment of chronic obstructive pulmonary disease (COPD) according to the 2017 GOLD guidelines, to determine the level of pulmonologist adherence and to identify possible factors that influence physician adherence. Materials and methods: This retrospective study took place between 1 February and 30 April 2018 in Pneumophtysiology Clinical Hospital Cluj-Napoca. We included 348 stable COPD outpatients classified according to the 2017 GOLD strategy in the ABCD risk groups. Pulmonologist adherence was defined as appropriate if the recommended pharmacological therapy was the first- or alternative-choice drug according to the guidelines, and inappropriate (overtreatment, undertreatment) if it was not in line with these recommendations. Results: The most prescribed treatment was the combination long-acting beta agonist (LABA) + long-acting antimuscarinic agent (LAMA) (34.77%), followed by LAMA + LABA + inhaled corticosteroid (ICS). Overall, pneumologist adherence was 79.02%. The most inappropriate therapies were in Group B (33.57%), followed by 33.33% in Group A. Compared to Groups C and D (analyzed together), Groups A and B had a 4.65 times higher chance (p = 0.0000001) of receiving an inappropriate therapy. Patients with cardiovascular comorbidities had a 1.89 times higher risk of receiving an inappropriate therapy (p = 0.021). ICS overprescription was the most common type of inappropriateness (17.81%). Groups C and D had a 3.12 times higher chance of being prescribed ICS compared to Groups A and B (p = 0.0000004). Conclusions: Pulmonologist adherence to the GOLD guidelines is not optimal and needs to be improved. Among the factors that influence the inappropriateness of COPD treatments, cardiovascular comorbidities and low-risk Groups A and B are important. ICS represent the most prescribed overtreatment. Further multicentric studies are needed to evaluate all factors that might influence the adherence rate.

Pulmonologists

Lama

Obstructive lung disease

10.3390/medicina56090422

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COPD in Firefighters: A Specific Event-Related Condition Rather than a Common Occupational Respiratory Disorder

Medicina (2022)

Armand Râjnoveanu Ruxandra Râjnoveanu Nicoleta Ștefania Motoc Paraschiva Postolache Gabriel Gușetu

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Smoking remains the most important risk factor, but occupational exposures may play an essential role as well. Firefighters are among occupations regularly exposed to a variety of irritative inhalational products, and they may be expected to develop respiratory health problems because of such an occupational exposure. To better understand and characterize this relationship, we performed an extensive search of the scientific literature, and we identified two major research areas: firefighters exposed to wildland fire smoke and firefighters involved in the World Trade Centre disaster-related operations. Most of the studies did not report a significant increase in COPD diagnosis in firefighters. An accelerated rate of decline in lung function was seen, a short time after major exposure events. This is the reason for an increased rate of exacerbations observed in individuals already diagnosed with obstructive respiratory disorders. A limited number of studies not covering these specific circumstances of exposure were found. They reported long-term morbidity and mortality data, and the results are controversial. Major confounding factors for most of the studies were the "healthy worker effect" and the lack of useful data regarding smoking habits. Efforts should be made in the future to better characterize specific biomarkers for the progression of COPD; to establish exposure limits; and to implement preventive strategies like rotation of workers, smoking cessation programs, and long-term monitoring programs for respiratory disorders.

Tobacco smoke

10.3390/medicina58020239

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Citations (8)

Relationship Between Obstructive Sleep Apnoea, Oxygen Desaturation and Cardiovascular Risk

Revista de Chimie (2019)

Lavinia Davidescu Ben Mansour Mohamed Azzedine Milena Adina Man Nicoleta Ștefania Motoc Ioan Anton Arghir

Obstructive sleep apnoea syndrome (OSAS) increases the risk cardiovascular events regardless of the presence of previous cardiovascular disease. As both OSAS and coronary heart disease (CHD) have same risk factors it’s often difficult to quantify the proportion of each risk factor in developing cardiac events. The aim of this study was to evaluate the 10-year risk of developing a coronary heart disease (CHD) event or stroke in newly diagnosed OSAS patients. 65 patients diagnosed with OSAS over a period of four months in Oradea Sleep Laboratory were included. Demographic characteristics, anthropometric parameters, clinical and biochemical data, sleep disorder and daytime sleepiness assessment, results of polysomnography were collected in all patients. In 55 selected patients by age range from 34 to 74 years old, cardiovascular risk was assessed using Framingham score calculator. Statistical analysis was performed using SPSS-PC version 7.5 and Stata 10.The estimated 10-years risk of a CHD event was 18.97% (± 9.67) in all cases. It was higher in men (22.17% ± 9.24) compare to women (12.39% ± 6.92) and it was not significantly different by stages of OSAS severity (20.58% ±9.41 in patients with severe OSAS versus 15.4% in mild OSAS), suggesting that apnea hypopnea index is not a major confounding factor. Desaturation of oxygen is a better outcome to define the relation between OSAS and cardiovascular diseases. OSAS and cardiovascular risk factors increased risk for future adverse cardiovascular events related to the severity of oxygen desaturation. Keywords: obstructive sleep apnoea syndrome, cardiovascular events, risk factors, oxygen desaturation

Stroke

10.37358/rc.19.10.3582

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Citations (1)

The Overlap Syndrome Prevalence and Risk Factors Among Patients Diagnosed With Different Pulmonary Obstructive Disorders

CHEST Journal (2010)

Elena Danteș Milena Adina Man Oana Cristina Arghir

PURPOSE: Indentifying the prevalence and risk factors of overlapping lung obstructive diseases (overlap syndrome) among airway obstructive symptomatic patients admitted in 2005 in a clinical pneumology setting from south-eastern part of Romania, Constantza.

Overlap syndrome

10.1378/chest.10632

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Neutrophil-to-lymphocyte ratio, platelets-to-lymphocyte ratio, and eosinophils correlation with high-resolution computer tomography severity score in COVID-19 patients

PLoS ONE (2021)

Milena Adina Man Ruxandra-Mioara Rajnoveanu Nicoleta Ștefania Motoc Cosmina Ioana Bondor Ana Florica Chiş

Inflammation has an important role in the progression of various viral pneumonia, including COVID-19. Circulating biomarkers that can evaluate inflammation and immune status are potentially useful in diagnosing and prognosis of COVID-19 patients. Even more so when they are a part of the routine evaluation, chest CT could have even higher diagnostic accuracy than RT-PCT alone in a suggestive clinical context. This study aims to evaluate the correlation between inflammatory markers such as neutrophil-to-lymphocyte ratio (NLR), platelets-to-lymphocytes ratio (PLR), and eosinophils with the severity of CT lesions in patients with COVID-19. The second objective was to seek a statically significant cut-off value for NLR and PLR that could suggest COVID-19. Correlation of both NLR and PLR with already established inflammatory markers such as CRP, ESR, and those specific for COVID-19 (ferritin, D-dimers, and eosinophils) were also evaluated. One hundred forty-nine patients with confirmed COVID-19 disease and 149 age-matched control were evaluated through blood tests, and COVID-19 patients had thorax CT performed. Both NLR and PLR correlated positive chest CT scan severity. Both NLR and PLR correlated positive chest CT scan severity. When NLR value is below 5.04, CT score is lower than 3 with a probability of 94%, while when NLR is higher than 5.04, the probability of severe CT changes is only 50%. For eosinophils, a value of 0.35% corresponds to chest CT severity of 2 (Se = 0.88, Sp = 0.43, AUC = 0.661, 95% CI (0.544; 0.779), p = 0.021. NLR and PLR had significantly higher values in COVID-19 patients. In our study a NLR = 2.90 and PLR = 186 have a good specificity (0.89, p = 0.001, respectively 0.92, p<0.001). Higher levels in NLR, PLR should prompt the clinician to prescribe a thorax CT as it could reveal important lesions that could influence the patient’s future management.

10.1371/journal.pone.0252599

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The Role of Pulmonary Rehabilitation in Patients with Idiopathic Pulmonary Fibrosis

IntechOpen eBooks (2019)

Elena Danteș Emanuela Tudorache Milena Adina Man

Idiopathic pulmonary fibrosis (IPF) is known as one of the most severe lung conditions and the worst form of interstitial lung disease (ILD). There is a continuing concern about clinical research to identify new therapies that influence the quality of life in patients diagnosed with this chronic progressive pulmonary disease, with an average survival of 3–5 years. Although in recent years great progress has been made to slow down the functional decline of the disease with new antifibrotic therapies, it has failed to alter the prognosis and survival of IPF patients. Clinical trials and recent ATS/ERS guidelines have brought at least moderate and low levels of evidence for increased effort tolerance, decreased symptoms, and improved quality of life following participation in lung rehabilitation programs for ILD patients and in particular those with IPF. Pulmonary rehabilitation has been shown to be a standard of care for COPD patients, but their personalized application to patients with IPF has had positive short-term results, becoming a safe alternative to non-pharmacological treatment. The chapter includes the general objectives of rehabilitation programs, their type and structure, ways of complex assessment of patients before and after a training exercise, types of exercises, and short- and long-term results.

10.5772/intechopen.84283

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Citations (3)