<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec>
<h3>CASE REPORTS</h3>
<p><bold>Combination with reserved prognosis: TB- rheumatoid arthritis –</bold> Simona Roșu, Diana-Sabina Tiba, Alexandru Ichim, Mara Bălteanu</p>
<p><bold>Myelomatous Malignant Pleural Effusion: A Rare Case Report –</bold> Shirin Jamshidi, Farzaneh Akbari, Parisa Vedad, Fariba Rezaeetalab, Seyedeh Zahra Banihashemian</p>
<p><bold>Endobronchial ultrasound: Indispensable or Dispensable- Our experience through Case Series –</bold> Unnati Desai, Ketaki Utpat, Kanmani MK, Vinod Pal, Sucheta Bhalerao, Rakesh Rajpurohit, Neenu N, Vitthal Chintalwar</p>
<p><bold>Proton Pump Inhibitors: Promising Role in the Prophylaxis and Symptom Control of Acute Exacerbations of Chronic Obstructive Pulmonary Disease –</bold> Iqbal Akhtar Khan</p>
</sec>
<sec>
<h3>ORIGINAL PAPER</h3>
<p><bold>Evaluation of CXCL 10 and IL-10 in COVID-19 pneumonia –</bold> Hayder Fadhil Okab, Manal Badi Salih, Bassim Abdulhussein Jarulla</p>
<p><bold>A framework for the identification of competencies required from Syrian pulmonologists during COVID-19 pandemic –</bold> Mohsen Shaheen, Zuhair Al-Nerabieah, Mayssoon Dashash</p>
</sec>
<sec>
<h3>GENERAL REVIEW</h3>
<p><bold>Lung cancer screening – a necessity? – Brief literature review –</bold> Ioana-Madalina Mosteanu, Luiza-Ana Iorga, Beatrice Mahler</p>
</sec>
<sec>
<h3>EDITORIAL</h3>
<p><bold>RSV Burden of Disease in Adults - a new threat –</bold> Florin Mihălțan, UMF. C. Davila</p>
</sec>
</abstract>

Summary

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>As shown in a Spanish study, patients with rheumatoid arthritis (PAR) have a 4-fold increased risk of developing TB (tuberculosis) compared to the general population. Abruptly stopping anti-TNF (tumor necrosis factor α) agents after the development of TB could cause a paradoxical response leading to severe complications and death. We present the case of a 54 years old female patient with seropositive PAR since 2012 in treatment with biological therapy, which was diagnosed 10 years after the start of immunosuppressive treatment with miliary TB. She has had an unfavorable prognosis, dying after one month from the initiation of antituberculosis treatment due to septic shock. Therefore, it is very important to evaluate the bacillary status before initiating any immunosuppressive treatment.</p>
</abstract>

Combination with reserved prognosis: TB- rheumatoid arthritis

<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec>
<h3>Background</h3>
<p>Multiple myeloma (MM) is a malignant disorder of plasma cells and includes 1% of all malignancies and 10% to 13% of hematologic cancers. Multiple myeloma, characterized by malignant proliferation of plasma cells, leads to the production of monoclonal immunoglobulins. Pleural involvement by plasma cells in multiple myeloma is rare.</p>
</sec>
<sec>
<h3>Case Report</h3>
<p>We report a 61-year-old woman with myelomatous pleural effusion in MM.</p>
</sec>
<sec>
<h3>Conclusion</h3>
<p>A few cases of pleural effusion secondary to MM, in literature, with an incidence of less than 1%, were reported.</p>
</sec>
</abstract>

Myelomatous Malignant Pleural Effusion: A Rare Case Report

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>EBUS has been an important interventional Pulmonology (IP) tool in respiratory medicine practice. We enlist our observations after including EBUS in our services.</p>
<p>A total of 35 cases referred for EBUS were assessed. Of these, 33 underwent linear EBUS and 2 VBN. EBUS could be done in 21/33 (63.6%) cases. In 12/33 (36.4%), EBUS was not done as it was unindicated or due to contraindications. Of the 21 cases wherein EBUS was performed, FNA/FNB could be done in 17 (81%) but could not be done on 4 (19%). Of these 17 cases, FNA/FNB was conclusive in 9 (53%), inconclusive with alternate site biopsy yielding diagnosis in 6 (35%), and inconclusive with no other biopsy evidence in 2(12%). The final etiology in the 35 cases was TB, malignancy, sarcoidosis, and others in 19 (54%), 9(26%), 3 (9%), and 4 (11%) cases, respectively. Of the 12/19 cases of TB wherein EBUS FNA/FNB was feasible, 8 were diagnostic (all cases of IMHL), 3 yielded diagnosis on other EP site biopsies, and in one case, no biopsy could be done. EBUS, while optional, proves indispensable in situations like IMHL (Isolated Mediastinal and Hilar Lymphadenopathy). The utility of TB was important to achieving biopsy evidence.</p>
</abstract>

Endobronchial ultrasound: Indispensable or Dispensable- Our experience through Case Series

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Chronic Obstructive Pulmonary Disease (COPD), the third leading cause of death worldwide and the fifth-ranked cause of chronic disability is usually associated with significant concomitant chronic diseases, Gastroesophageal Reflux Disease (GERD) being the commonest. Exacerbations of COPD (AECOPD) are episodes of worsening of symptoms, the frequency of which increases with the severity of COPD. AECOPD is triggered mainly by respiratory infections, bacterial or viral or both. Human rhinoviruses (HRV) are the top viral pathogen in triggering AECOPD, and experimental infection has provided significant new evidence in establishing a causal relationship between virus infections and AECOPD.</p>
<p>Proton pump inhibitors (PPI), the most potent acid suppressants, are commonly prescribed for isolated GERD or GERD complicating COPD. There has been a breakthrough in Pulmonary Medicine in that PPI, in addition to their well proven role in acid suppression, has emerged as a promising interventional tool in the prophylaxis and symptom control of AECOPD. This efficacy is not limited to patients with COPD complicated by GERD, since PPI also independently and significantly reduced the risk of developing frequent AECOPD in those with COPD alone, delaying disease progression and improving clinical outcomes.</p>
<p>Although the studies conducted so far regarding effectiveness of PPI had promising results, current evidence is insufficient to determine to what extent their long-term use is safe. Large scale multi-center studies are warranted to assess their long-term safety profile and clinical outcomes.</p>
<p>The objective of this study is to identify a possible role of PPI in prophylaxis and symptom control of AECOPD.</p>
</abstract>

Proton Pump Inhibitors: Promising Role in the Prophylaxis and Symptom Control of Acute Exacerbations of Chronic Obstructive Pulmonary Disease

<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec>
<h3>Background</h3>
<p>Dysregulation the immune system is characteristic of the severe stages of COVID-19 disease; therefore, the study aimed to highlight the defective immune regulation patients with COVID-19 pneumonia without chronic diseases.</p>
</sec>
<sec>
<h3>Methods</h3>
<p>The study included 180 individuals, 60 as a control group, and 120 patients with COVID-19, including 67 males and 53 females, whose ages ranged from 27 to 70 years, at Imam Al-Hussein Teaching Hospital in Thi-Qar Province, South of Iraq. The CXCL 10 and IL-10 were evaluated by enzyme-linked immunosorbent assay (ELISA).</p>
</sec>
<sec>
<h3>Results</h3>
<p>The current study recorded that CXCL 10 was significantly increased &lt; 0.001 in patients compared to controls, while the IL-10 was decreased significantly in patients, within disease severity the CXCL 10 increased with progress of disease, and IL-10 increased in sever patients, according to BMI the CXCL 10 decrease in obese patients than over and normal weight, while IL-10 increased in normal weight patients.</p>
</sec>
<sec>
<h3>Conclusion</h3>
<p>This study investigated the CXCL 10 was highly elevated in COVID-19 patients than control group, also noted the CXCL 10 increased with disease progress, therefor consider a good marker for poor outcome, furthermore the obese patients are more likely to have severe outcomes than others, so BMI is considered a risk factor for patients.</p>
</sec>
</abstract>

Evaluation of CXCL 10 and IL-10 in COVID-19 pneumonia

<abstract xmlns="http://www.w3.org/1999/xhtml">

<sec>
<h3>Objective</h3>
<p>To identify essential competencies required for equipping pulmonologists to manage respiratory diseases such as the Covid-19 pandemic.</p>
</sec>
<sec>
<h3>Methods</h3>
<p>A descriptive and qualitative study was conducted. Focus group, which consisted of five Syrian members who were affiliated with the Syrian Association of Thoracic Medicine and Surgery were invited to formulate a preliminary list of competencies. Delphi technique with three cycles was also employed to evaluate the resulted list. The number of pulmonologists who accepted to take part was 67 out of 110. All competencies suggested by at least 80% of experts were included in the final list. Reliability was tested using Cronbach’s alpha, Descriptive statistics including Mean and standard deviation were performed.</p>
</sec>
<sec>
<h3>Findings</h3>
<p>Forty-five essential competencies were identified including ten competencies in cognitive domain, 11 skills, and 24 competencies related to attitude domain.</p>
</sec>
<sec>
<h3>Conclusion</h3>
<p>A list of 45 competencies has been identified. It is hoped that they will guide and enable pulmonologists to provide the best health care to patients with respiratory infections, especially during the COVID-19 pandemic. It will also guide decision makers to design training programs that can address these competencies.</p>
</sec>
</abstract>

A framework for the identification of competencies required from Syrian pulmonologists during COVID-19 pandemic

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Lung cancer ranks among the first in terms of mortality rates in the world, which is why a screening program for people at risk is imperative. However, nowadays, thanks to new diagnostic technologies and oncological therapies, lung cancer has maybe come to be classified as a chronic disease. Low-dose computer tomography is currently the best method for lung cancer screening, and the screening criteria are already established internationally. Very important is the psychological or therapeutical support given to patients in the attempt to quit smoking, as well as other methods of prevention and combating pollution.</p>
</abstract>

Lung cancer screening – a necessity? – Brief literature review

<abstract xmlns="http://www.w3.org/1999/xhtml">

<p>Respiratory syncytial virus (RSV) is responsible for lower respiratory tract infections across all age groups worldwide. Initial exposure to RSV in infants and young children can lead to severe bronchiolitis, which has the potential to be life-threatening. Among older children and healthy adults, recurrent upper respiratory tract infections caused by RSV are frequent, varying in intensity from asymptomatic infection to symptomatic upper respiratory tract disease. The presence of specific comorbidities (cardiopulmonary conditions, including COPD and CHF, and immunocompromising conditions) increases the likelihood of severe disease in adults (<xref ref-type="bibr" rid="j_pneum-2023-0046_ref_001">1</xref>).</p>
<p>This editorial provides a review of the burden of RSV disease among adults, population groups at increased risk of developing severe RSV disease, the current status of surveillance systems and RSV prevention strategies in adults, including the use of RSV vaccines in adults, recently licensed for use.</p>
</abstract>

RSV Burden of Disease in Adults - a new threat

AHEAD OF PRINT

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Pneumologia

 Pneumologia is the journal of the Romanian Society of Pneumology, being continuously edited since 1951. Pneumologia is an open-access journal, edited in English, 4 issues per year and is included in international databases. It publishes clinical and experimental research articles in the field of respiratory medicine, paediatrics, thoracic surgery, allergology, respiratory intensive care and oncology.  Pneumologia aims to publish scientifically valid papers, related to the respiratory field, offering a good visibility of the published papers. It is also an educational platform for physicians, educators interested in this domain, and aims to promote research and good clinical practice.  Pneumologia publishes original articles in the field of respiratory medicine, paediatrics, thoracic surgery, allergology, respiratory intensive care, and oncology. The following types of submissions are accepted:   Original research papers  Case reports  Reviews  Letters to the editor  Educational materials: practice guidelines, new techniques description and use  News, chronicles   All submitted papers are confidentially peer-reviewed in a timely manner, by at least two independent reviewers selected according to the topic of the article. The peer-review process aims to check the originality, scientific validity, and coherence of the submission.  Pneumologia offers fast publication; the eligible submissions are typically published within 3 months. There is no publication fee, and the online version is available open access on the Journal’s web site. The printed journal is distributed to the members of the Romanian Society of Pneumology and several public libraries.  Romanian and international authors are welcome to submit papers to Pneumologia, which is one of the few journals specifically dedicated to respiratory medicine in the region.  Archiving  Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.  Plagiarism Policy  The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process.  Back issues www.pneumologia.eu/en/all-articles arhiva.pneumologia.eu/ 

Pneumologia

Volume 71 (2022): Issue 4 (December 2022)

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