Ana Florica Chiş

Iuliu Hațieganu University of Medicine and Pharmacy

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Doina Adina Todea

Iuliu Hațieganu University of Medicine and Pharmacy

Milena Adina Man

Iuliu Hațieganu University of Medicine and Pharmacy

NȘ

Nicoleta Ștefania Motoc

Iuliu Hațieganu University of Medicine and Pharmacy

Ruxandra Râjnoveanu

Iuliu Hațieganu University of Medicine and Pharmacy

Carmen Monica Pop

Iuliu Hațieganu University of Medicine and Pharmacy

Bogdan Augustin Chiș

Iuliu Hațieganu University of Medicine and Pharmacy

Anca Diana Maierean

Iuliu Hațieganu University of Medicine and Pharmacy

Elena Danteș

Ovidius University

Andrei Leșan

Iuliu Hațieganu University of Medicine and Pharmacy

Ioana Roxana Bordea

Iuliu Hațieganu University of Medicine and Pharmacy

Cooperative Institutions

Iuliu Hațieganu University of Medicine and Pharmacy

Clinica de Pneumologie Iaşi

Clinical Emergency Hospital Bucharest

University of Agricultural Sciences and Veterinary Medicine of Cluj-Napoca

Carol Davila University of Medicine and Pharmacy

Spitalul Clinic Județean de Urgență Cluj-Napoca

Ovidius University

Constanta Maritime University

University of Oradea

Weatherford College

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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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Citations (16)

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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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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Citations (63)

Increased Vascular Endothelial Growth Factor Serum Level and the Role of +936C/T Gene Polymorphism in Chronic Obstructive Pulmonary Disease

Medicina (2021)

Ana Florica Chiş Ruxandra Râjnoveanu Milena Adina Man Doina Adina Todea Bogdan Augustin Chiș

Background and Objectives: Chronic obstructive pulmonary disease (COPD) represents a debilitating disease, with rising morbidity and mortality. Vascular endothelial growth factor (VEGF) plays a major role in angiogenesis, vascular permeability, and airway remodeling. The purpose of this study was to investigate the relationship between VEGF serum levels and VEGF +936 C/T gene polymorphism (rs3025039) with COPD, for the first time in a Romanian population. Materials and Methods: In total, 120 participants from Transylvania were included in this case-control study. Serum levels of VEGF were determined using an enzyme-linked immune-sorbent assay and rs3025039 was investigated by high molecular weight genomic deoxyribonucleic acid (DNA). Spirometric values, arterial blood gas analysis, and the Six Minute Walk Test (6MWT) outcome were also determined. Results: The serum level of VEGF was higher in the COPD group versus controls (p < 0.001), with a positive correlation with the 6MWT outcome. No significant difference was observed in the VEGF serum levels between VEGF +936C/T genotypes. There was no difference in the VEGF +936C/T genotype between COPD patients and healthy subjects (chi2 test p = 0.92, OR = 1.04, 95%CI = 0.41-2.62), but the presence of the T allele was significantly linked to the presence of COPD (chi2 test p = 0.02, OR = 2.36, 95%CI = 1.12-4.97). Conclusions: Higher VEGF serum levels were found in moderate and severe COPD and were positively correlated with the distance in the 6MWT. No significant difference was found between CC, CT, and TT genotypes of rs3025039 and the presence of COPD. The presence of the T allele was found to be linked to COPD and also to the degree of airway obstruction.

10.3390/medicina57121351

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Citations (1)

Six-minute walk test outcome in COPD patients

Palestrica of the third millennium - Civilization and Sport (2018)

Ana Florica Chiş Ruxandra Râjnoveanu Milena Adina Man Doina Adina Todea Bogdan Augustin Chiș

10.26659/pm3.2018.19.3.170

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A Prospective Study of CPAP Therapy in Relation to Cardiovascular Outcome in a Cohort of Romanian Obstructive Sleep Apnea Patients

Journal of Personalized Medicine (2021)

Ioana Maria Chețan Anca Diana Maierean Bianca Domokos Hancu Georgiana Cabău Raluca Tomoaia

Despite efforts at treatment, obstructive sleep apnea (OSA) remains a major health problem, especially with increasing evidence showing an association with cardiovascular morbidity and mortality. The treatment of choice for OSA patients is Continuous Positive Airway Pressure (CPAP), which has been proven in randomized controlled trials to be an effective therapy for this condition. The impact of CPAP on the cardiovascular pathology associated with OSA remains, however, unclear. Although the effect of CPAP has been previously studied in relation to cardiovascular outcome, follow-up of the treatment impact on cardiovascular risk factors at one year of therapy is lacking in a Romanian population. Thus, we aimed to evaluate the one-year effect of CPAP therapy on lipid profile, inflammatory state, blood pressure and cardiac function, assessed by echocardiography, on a cohort of Romanian OSA patients.We enrolled 163 participants and recorded their baseline demographic and clinical characteristics with a follow-up after 12 months. Inflammatory and cardiovascular risk factors were assessed at baseline and follow up.Our results show that CPAP therapy leads to attenuation of cardiovascular risk factors including echocardiographic parameters, while having no effect on inflammatory markers.Treatment of OSA with CPAP proved to have beneficial effects on some of the cardiovascular risk factors while others remained unchanged, raising new questions for research into the treatment and management of OSA patients.

10.3390/jpm11101001

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Citations (7)

The role of 3D speckle tracking echocardiography in the diagnosis of obstructive sleep apnea and its severity

Scientific Reports (2022)

Ioana Maria Chețan Bianca Domokos Hancu Ruxandra Beyer Raluca Tomoaia Georgiana Cabău

There is a consistent relationship between obstructive sleep apnea (OSA) and cardiovascular diseases. It is already recognized that OSA may influence the geometry and function of the right ventricle (RV). This has encouraged the development of echocardiographic evaluation for screening of OSA and its severity. Three-dimensional speckle tracking echocardiography (3D STE) is in assumption better, compared with 2D STE, because it overcomes the standard 2D echo limitations. Thus, the purpose of our study is to evaluate whether 3D STE measurements, could predict the positive diagnosis and severity of OSA. We enrolled 69 patients with OSA and 37 healthy volunteers who underwent a cardiorespiratory sleep study. 2DE was performed in all patients. RVEF and 3D RVGLS were measured by 3DSTE. NT pro BNP plasma level was also assessed in all participants. 3D RV GLS (- 13.5% vs. - 22.3%, p < 0.001) and 3D RVEF (31.9% vs. 50%, p < 0.001) were reduced in patients with OSA, compared with normal individuals. 3D Strain parameters showed better correlation to standard 2D variables, than 3D RVEF. Except for NT pro BNP (p = 0.059), all parameters served to distinguish between severe and mild-moderate cases of OSA. 3D STE may be a reliable and accurate method for predicting OSA. Consequently, 3D RV GLS is a good tool of assessing the RV global function in OSA, because it correlates well with other established measurements of RV systolic function. Furthermore, 3D RV GLS was a precise parameter in identifying severe cases of OSA, while NT pro BNP showed no association.

Speckle tracking echocardiography

10.1038/s41598-022-26940-2

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Citations (3)

Smoking during pregnancy: a survey of women “knowledge” and behavior

Nicoleta Ștefania Motoc Roxana Vancea Daisy Am Vaida Voevod Ruxandra Râjnoveanu Ana Florica Chiş

Smoking during pregnancy is the leading cause of prenatal morbidity and is associated with increased risk for numerous maternal, fetal, and infant complications. The aim of this paper was to assess the level of knowledge about maternal and fetal risk factors associated with tobacco use in pregnancy. An online self report questionnaire, concerning smoking behavior during pregnancy, was applied to women who were either pregnant, either recently gave birth using social networking and dedicated sites, from November 2016 to February 2017 in Romania. 1347 women replied and were eligible to be included in the study. They were divided into active smokers, former smokers and never smokers. 85% of all women knew that smoking has bad effects on their health and their babies. 42.9% among former smokers, 33.8% of active smokers and 31.5 % of never smokers had a good knowledge about smoking effects. Despite that 75% of them continued smoking even though they knew that the nicotine reaches breast milk. Among all respondents 43.21% gave up smoking, 36.8 % reduced the number of cigarettes when learning that they were pregnant. The main reason for giving up smoking among pregnant women was family pressure (75.1%) The most frequent complications was preeclampsia, which interestingly was higher among never smokers that smokers (1.2% active smokers, 2.2% of former smokers (p=0.0016), never smokers 3.21%). Smoking during pregnancy, both passive and active, is a health problem that needs to be address, not only through health policies but also through behavioral therapy.

Passive smoking

10.1183/13993003.congress-2019.pa4471

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Citations (3)

Disease Perception and Coping with Emotional Distress During COVID-19 Pandemic: A Survey Among Medical Staff

International Journal of Environmental Research and Public Health (2020)

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

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

Pandemic

Perceived Stress Scale

10.3390/ijerph17134899

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Citations (127)

Gaucher disease - therapeutic aspects in Romania

Medicine and Pharmacy Reports (2021)

Bogdan Augustin Chiș Ana Florica Chiş Dan L. Dumitraşcu

Gaucher disease is a rare autosomal recessive disease caused by the beta-glicosidase activity deficiency, which will lead to substrate accumulation mainly in the liver, spleen or bone marrow. The main symptoms are liver and spleen enlargement, anemia and low platelet count, bone crisis and fatigue. Several treatment options are available, as enzyme replacement therapy, substrate reduction therapy, or chaperones treatment whose effect is still studied. There are 77 adult patients treated at this time in Romania, 54 with intravenous enzyme replacement ant 23 with oral substrate reduction therapy. No severe adverse effects have been reported by now. All patients had improved disease related symptoms after the receiving of the treatment.

Substrate reduction therapy

Gaucher's disease

Beta thalassemia

10.15386/mpr-2230

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Citations (1)