Stefan Dumitrache‐Rujinski

Institutul de Pneumoftiziologie "Marius Nasta"

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Miron Alexandru Bogdan

Institutul de Pneumoftiziologie "Marius Nasta"

Claudia Toma

Carol Davila University of Medicine and Pharmacy

Ionela Belaconi

Carol Davila University of Medicine and Pharmacy

Alina Croitoru

Institutul de Pneumoftiziologie "Marius Nasta"

Cornelia Tudose

Carol Davila University of Medicine and Pharmacy

Dragoş Zaharia

Carol Davila University of Medicine and Pharmacy

Ionela Erhan

Carol I National Defence University

Diana Leonte

Institutul de Pneumoftiziologie "Marius Nasta"

Tudor Constantinescu

Carol Davila University of Medicine and Pharmacy

Miron Bogdan

Carol Davila University of Medicine and Pharmacy

Cooperative Institutions

Carol Davila University of Medicine and Pharmacy

Institutul de Pneumoftiziologie "Marius Nasta"

Clinical Emergency Hospital Bucharest

Tumori Foundation

Clinica de Pneumologie Iaşi

Hopital Universitaire Hedi Chaker

University of Sfax

Grigore T. Popa University of Medicine and Pharmacy

Emergency University

Institutul Oncologic Bucuresti

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Étude rétrospective des 472 des cas de carcinome bronchopulmonaire dans un service de pneumologie en Roumanie. Analyse de la classification TNM, forme histologique, traitement et survie

Ayşen Cücü Catelin Toma Stefan Dumitrache‐Rujinski Cornelia Tudose Dragoş Bumbăcea

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P1.04-010 Neutrophil to Lymphocyte, Platelet to Lymphocyte Ratios and Systemic Inflammation in Lung Cancer Stages

Journal of Thoracic Oncology (2017)

Erhan Ionela Mihaela Stefan Dumitrache‐Rujinski Stroescu Carmen Miron Bogdan

Erythrocyte sedimentation rate

Absolute neutrophil count

10.1016/j.jtho.2016.11.766

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Correlations between respiratory muscle strength, functional and non-functional parameters in COPD patients

Alina Croitoru Diana Ioniţă Daniela Gologanu Irina Pele Stefan Dumitrache‐Rujinski

Introduction: This study analyzed the respiratory muscle strength in a group of COPD patients and the possible relationship with other functional and non-functional parameters. Subjects and methods : In consecutives, stable COPD patients were evaluated: respiratory muscle strength (maximal inspiratory pressure MIP, maximal expiratory pressure MEP), lung function tests (FEV1, residual volume RV, functional residual capacity FRC), 6 minutes walking test (6MWT), modified Medical Research Council dyspnea scale (mMRC), COPD Assessment Test (CAT), St. George Respiratory Questionnaire (SGRQ), Hospital Anxiety and Depression Scale (HADS). Results: 70 COPD patients: 11 females / 59 males. Mean age 62.2±11 years. Mean MEP value: 125.4 ±40 cm H20. Mean MIP value: 67.5 ±23 cm H20. Both MIP and MEP values were correlated positively with: 6MWT distance, FEV1 values (p<0.05), and negatively with: dyspnea, age (p<0.05). MEP value was correlated with weight (p<0.05). No relationship was found with RV, FRC values or with CAT, SGRQ, HADS questionnaires. Concerning the MIP, the lowest values were in stage II GOLD (60.1 cm H20) and in 41.4% of cases the values were < 60 cm H20 (inspiratory muscle fatigue threshold). Conclusions: In our group of COPD patients, respiratory muscle pressures were in relationship with age, weight, dyspnea, FEV1 values and 6MWT distance. Inspiratory muscle pressure was seriously affected in almost half of patients.

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Treatment options in stage III non-small cell lung cancer.

PubMed (2016)

Bianca Paraschiv Camelia Cristina Diaconu Stefan Dumitrache‐Rujinski Ionela Belaconi Tudor Constantinescu

Lung cancer is responsible for over 1 million deaths annually, worldwide. The disease becomes symptomatic in advanced stages, so the diagnosis is delayed and 90% of cases cannot benefit from a curative treatment. In NSCLC surgical resection represents the best option for long term survival in resectable stage III and in clinical stage I/II. Patients with stage IIIB or IV usually receive chemotherapy or palliative treatment. For patients with no driver mutation detected platinum based combination chemotherapy is the first choice. Definitive radiotherapy is considered an lternative for patients who are not candidates for combined modality treatment. When a stage IV cancer is diagnosed based on an isolated metastasis, the patient’s benefit from the removal of the etastasis and of the primary tumor if it is resectable. The prognosis in NSLC is mainly influenced by the TNM stage at diagnosis. The rate of survival decreases in opposing correlation with the stage of the cancer. Poor performance status, reduced lung capacity, weight loss, vascular invasion are indicators for a poor prognosis

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The role of overnight pulse-oximetry in recognition of obstructive sleep apnea syndrome in morbidly obese and non obese patients.

PubMed (2013)

Stefan Dumitrache‐Rujinski George Călcăianu Dragoş Zaharia Claudia Toma Miron Alexandru Bogdan

We prospectively evaluated 199 individuals with high pre-test clinical suspicion of OSAS. Of these, 123 patients were morbidly obese (Group A) and 76 were non-obese (Group B). We performed six channel cardio-respiratory polygraphy and assessed the correlation between the Desaturation Index (DI) and the Apnea Hypopnea Index (AHI) for both groups.In group A: 116 patients (94.3%) were diagnosed with OSAS (AHI>5/hour); mean age: 59.4±10.9 years; mean BMI: 44.8±4.9 kg/m(2). The mean DI was 47.2±27.6/hour and the mean AHI: 46.5±27.6/hour. Mean average SaO2 was 88.5±6.3 %. In group B, 65 patients (85.52%) were diagnosed with SAS; mean age: 51.2 ± 12.7 years; mean BMI: 27.24±2.2 kg/m(2).The mean DI was 23.12 ± 18.35/hour and the mean AHI: 28.8 ± 18.5/hour. Mean average SaO2 was 93.7±2.07 %.A significant positive correlation (correlation index rA = 0.863 and rB= 0.877) was found between DI and AHI in both groups (p<0.001).Assessment of the Desaturation Index by nocturnal pulse-oximetry maintains its utility as a screening method for OSAS in both obese and non-obese patients with high clinical pre-test suspicion, despite the fact that the basal nocturnal saturation was found to be lower in group A.

Pulse Oximetry

Apnea–hypopnea index

Morbidly obese

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Apnea Hypopnea Index, Oxygen Desaturation Index, and QTC Interval in Obstructive Sleep Apnea

CHEST Journal (2015)

Stefan Dumitrache‐Rujinski Ionela Erhan Alexandru Cocieru Ionela Butuc-Andreescu Alexandru Muntean

Hypopnea

Apnea–hypopnea index

10.1378/chest.2281009

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Features of lung cancer in young people: Report of 14 cases

European Respiratory Journal (2012)

Bianca Paraschiv Claudia Toma Ionela Belaconi Stefan Dumitrache‐Rujinski Tudor Constantinescu

Introduction : Lung cancer is one of the most common cancers in all ages. Little is known about clinical factors associated with the development of lung cancer in young patients. That is why mistakes are often made in radiological diagnosis of lung cancer in young people. Method : In this report were included 14 patients admitted in our institute between 2003 and 2012, 8 males/6 females with the mean age of 29 years. Eight patients were non-smokers, 6 patients were smokers (10-65 pack-years).The patients were initially diagnosed with different lung diseases: asthma (2), pneumonia (7), tuberculosis (5). All patients were evaluated with chest X-ray, CT-scan, bronchoscopy. Results : Patients presented at the doctor for several symptoms: dyspnea, fatigue, cough in all cases, fever (2), wheezing (2). Ten patients had inflammatory syndrome. The radiological aspects were: lung tumor (11), multiple nodules (2), and atelectasis (1). All patients had negative exams for My. Tuberculosis. The mean delay of diagnosis was 3.5 months. Cancer was confirmed on histological examinations: bronchial biopsy (12), tumor removed during surgery (1), necropsy (1). The type of carcinoma was adenocarcinoma (6), epidermoid (7), macrocellular (1). Six patients died during initial hospitalization, 8 cases were operated and received postoperative chemotherapy. Conclusions : Lung cancer is unfortunately not the first diagnosis taken into account in young people with respiratory problems. The young patient9s condition deteriorates rapidly and the diagnosis of cancer is made when disease is already in an advanced stage. Diagnosis is often delayed and patients might lose the opportunity of curative treatment.

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Thoracic mechanics in COPD patients before and after pulmonary rehabilitation

European Respiratory Journal (2011)

Alina Croitoru Diana Ioniţă Carmen Stroescu Lucia Marinescu Stefan Dumitrache‐Rujinski

Background: Patients with COPD have severe breathlessness induced by the increased mechanical work of respiratory muscles in relation to dynamic hyperinflation. Pulmonary rehabilitation programs have been shown to relieve dyspneea, but the mechanism by which they succeed remains controversial. Aim: To evaluate the effect of pulmonary rehabilitation on thoracic mechanics. Method: The association between thoracic hyperinflation measured by plethysmography (functional residual capacity FRC, residual volume RV), respiratory muscle strength (maximal inspiratory pressure MIP, maximal expiratory pressure MEP) and dyspnoea scores (MRC scale) were analyzed in patients with stable COPD before and after pulmonary rehabilitation (outpatient program, 2 months, 3 sessions/week, including daily respiratory muscle training). Results: Twenty patients with COPD stage II-IV GOLD were included. Thoracic hyperinflation was present in all cases: mean FRC 164.9% of the predicted value and RV 209.2% before the rehabilitation program. Mean MIP was 69.6% and mean MEP 105.3%. The severity of dyspnoea before the pulmonary rehabilitation was negatively associated with inspiratory muscle strength (r -0.68) and hyperinflation (r -0.45). Hyperinflation decreased at the end of the rehabilitation program (mean RV decreased with 15.1% and mean FRC with 9.2%), mean MIP increased with 14.3% and the mean dyspnoea score decreased from 3.5 to 2.2. Conclusion: Pulmonary rehabilitation optimized thoracic mechanics in our patients by reducing thoracic hyperinflation and increasing the effectiveness of inspiratory muscles work.

Hyperinflation

Dynamic hyperinflation

Plethysmograph

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Respiratory Muscle Pressures in COPD Patients Stratified in Groups of Risk Acording to GOLD 2013 Classification

CHEST Journal (2014)

Alina Croitoru Daniela Jipa Diana Ioniţă Stefan Dumitrache‐Rujinski Paraschiva Postolache

10.1378/chest.1994304

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Lung function tests, exercise capacity and postoperative outcomes of patients with pulmonary resections

Pneumologia (2020)

Irina Pele Ciprian Bolca Stefan Dumitrache‐Rujinski Florin Mihălţan

Abstract Aim: Postoperative complications, especially pulmonary complications, are described after lung resections, with different risk factors involved. We evaluate the relationship between lung function, exercise test parameters and the occurrence of postoperative outcomes in patients with pulmonary resections. Methods: A 5 years prospective observational study on patients with lung resection (lobectomy, bilobectomy and pneumonectomy) for lung cancer and other pulmonary pathologies has been performed. All the patients were preoperatively evaluated using spirometry, plethysmography, diffusing capacity test and cardio-pulmonary exercise test (CPET). Data were analysed regarding the linkage between cardiopulmonary fitness and postoperative outcomes (respiratory complications and 90-day mortality). Results: Of 155 consecutive patients (109 male, mean age 61.2 ± 9.8 years), 130 (83.9%) underwent pulmonary resection for lung cancer. Nearly 24% of patients developed postoperative respiratory complications (mainly atelectasis, prolonged air leak and respiratory failure). The 90-day mortality was 5.2%. A reduced absolute value of forced expiratory volume in 1 s (FEV1) was found to be associated with postoperative atelectasis [odds ratio (OR) 0.33; 95% confidence interval (CI) 0.11–0.99], but with low accuracy. The most related variable and a predictor to prolonged air leak was FEV1/vital capacity (VC) ratio (OR 0.90; 95% CI 0.83–0.99). Patients who developed respiratory failure had lower values of static volumes and breathing reserve (BR%) compared to those without respiratory failure, but with no significant difference (P > 0.050). No relationship to mortality was noted. Conclusion: In our study group, lower values of FEV1 were related to postoperative atelectasis and obstructive dysfunction with persistent air leak, with no significant association with mortality.

Atelectasis

DLCO

Vital capacity

10.2478/pneum-2021-0005

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