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Article: Opioids in Treatment of Refractory Dyspnea in Chronic Obstructive Pulmonary Disease: Yes, No or Maybe.

Rajnoveanu, Ruxandra-Mioara / Harangus, Antonia / Todea, Doina Adina / Man, Milena Adina / Budin, Corina Eugenia / Rajnoveanu, Armand-Gabriel

Journal of personalized medicine

2024 Volume 14, Issue 3

Abstract: Chronic Obstructive Pulmonary Disease (COPD) is a complex condition with significant impact on prognosis, especially in advanced stages where symptom burden becomes critical. Breathlessness affects patients' quality of life, and despite various ... ...

Abstract	Chronic Obstructive Pulmonary Disease (COPD) is a complex condition with significant impact on prognosis, especially in advanced stages where symptom burden becomes critical. Breathlessness affects patients' quality of life, and despite various therapeutic strategies, the role of opioids in palliative care for COPD remains under investigation. The acceptance of a therapeutic trial of different types of opioids is increasing not only in end-of-life situations but also for stable COPD patients experiencing intolerable refractory breathlessness despite optimal conventional therapy. Recent clinical trials have raised questions about the overall clinical benefit of opioids in addressing breathlessness in COPD, prompting the need to clarify inconsistencies and identify specific subgroups that may benefit from opioid therapy. In the clinical setting, it is crucial to understand the attributes of patients who exhibit positive responses to opioids and what type of opioids could have a positive impact. This research paper aims to offer an update of the most recent evidence of opioid treatment in managing breathlessness among individuals with COPD with a head-to-head evaluation of the supporting and opposing proof in the medical literature.
Language	English
Publishing date	2024-03-19
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm14030318
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The Role of Lung Microbiome in Fibrotic Interstitial Lung Disease-A Systematic Review.

Puiu, Ruxandra / Motoc, Nicoleta Stefania / Lucaciu, Sergiu / Ruta, Maria Victoria / Rajnoveanu, Ruxandra-Mioara / Todea, Doina Adina / Man, Milena Adina

Biomolecules

2024 Volume 14, Issue 3

Abstract: Interstitial Lung Disease (ILD) involves lung disorders marked by chronic inflammation and fibrosis. ILDs include pathologies like idiopathic pulmonary fibrosis (IPF), connective tissue disease-associated ILD (CTD-ILD), hypersensitivity pneumonitis (HP) ... ...

Abstract	Interstitial Lung Disease (ILD) involves lung disorders marked by chronic inflammation and fibrosis. ILDs include pathologies like idiopathic pulmonary fibrosis (IPF), connective tissue disease-associated ILD (CTD-ILD), hypersensitivity pneumonitis (HP) or sarcoidosis. Existing data covers pathogenesis, diagnosis (especially using high-resolution computed tomography), and treatments like antifibrotic agents. Despite progress, ILD diagnosis and management remains challenging with significant morbidity and mortality. Recent focus is on Progressive Fibrosing ILD (PF-ILD), characterized by worsening symptoms and fibrosis on HRCT. Prevalence is around 30%, excluding IPF, with a poor prognosis. Early diagnosis is crucial for optimizing outcomes in PF-ILD individuals. The lung microbiome comprises all the microorganisms that are in the respiratory tract. Relatively recent research try to evaluate its role in respiratory disease. Healthy lungs have a diverse microbial community. An imbalance in bacterial composition, changes in bacterial metabolic activities, or changes in bacterial distribution within the lung termed dysbiosis is linked to conditions like COPD, asthma and ILDs. We conducted a systematic review of three important scientific data base using a focused search strategy to see how the lung microbiome is involved in the progression of ILDs. Results showed that some differences in the composition and quality of the lung microbiome exist in ILDs that show progressive fibrosing phenotype. The results seem to suggest that the lung microbiota could be involved in ILD progression, but more studies showing its exact pathophysiological mechanisms are needed.
MeSH term(s)	Humans ; Disease Progression ; Lung Diseases, Interstitial ; Lung ; Fibrosis ; Idiopathic Pulmonary Fibrosis
Language	English
Publishing date	2024-02-20
Publishing country	Switzerland
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	2701262-1
ISSN	2218-273X ; 2218-273X
ISSN (online)	2218-273X
ISSN	2218-273X
DOI	10.3390/biom14030247
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Article: Lung Microbiota in Idiopathic Pulmonary Fibrosis, Hypersensitivity Pneumonitis, and Unclassified Interstitial Lung Diseases: A Preliminary Pilot Study.

Man, Milena Adina / Ungur, Rodica Ana / Motoc, Nicoleta Stefania / Pop, Laura Ancuta / Berindan-Neagoe, Ioana / Ruta, Victoria Maria

Diagnostics (Basel, Switzerland)

2023 Volume 13, Issue 19

Abstract: 1) Introduction: Although historically, the lung has been considered a sterile organ, recent studies through 16S rRNA gene sequencing have identified a substantial number of microorganisms. The human microbiome has been considered an "essential organ," ... ...

Abstract	(1) Introduction: Although historically, the lung has been considered a sterile organ, recent studies through 16S rRNA gene sequencing have identified a substantial number of microorganisms. The human microbiome has been considered an "essential organ," carrying about 150 times more information (genes) than are found in the entire human genome. The purpose of the present study is to characterize and compare the microbiome in three different interstitial lung diseases: idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis, and nondifferential interstitial lung disease. (2) Material and methods: This was a prospective cohort study where the DNA of 28 patients with ILD was extracted from the lavage and then processed using the standard technique of 16S RNA gene sequencing. In a tertiary teaching hospital in the northern, western part of Romania, samples were collected through bronchoscopy and then processed. (3) Results: The same four species were found in all the patients but in different quantities and compositions:
Language	English
Publishing date	2023-10-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662336-5
ISSN	2075-4418
ISSN	2075-4418
DOI	10.3390/diagnostics13193157
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Article: Managing Severe Adverse Reactions to Biologicals in Severe Asthma.

Balan, Radu-Gheorghe / Deleanu, Diana Mihaela / Pintea, Irena / Dobrican Baruta, Carmen Teodora / Man, Milena Adina / Bocsan, Ioana Corina / Muntean, Ioana Adriana

Biomedicines

2023 Volume 11, Issue 12

Abstract: Background: The use of biological agents in the treatment of various inflammatory and malignancy conditions has expanded rapidly. However, these agents can induce hypersensitivity reactions, posing significant clinical challenges.: Methods: We ... ...

Abstract	Background: The use of biological agents in the treatment of various inflammatory and malignancy conditions has expanded rapidly. However, these agents can induce hypersensitivity reactions, posing significant clinical challenges. Methods: We conducted a retrospective study that included nine patients with severe asthma who experienced hypersensitivity reactions to biological agents (omalizumab, benralizumab and dupilumab). Results: Hypersensitivity reactions to biologicals in severe asthma were observed in 9 of 68 patients treated. In five cases, treatment was stopped or changed to another available biological, and for four patients administered under close surveillance, titrated provocation or desensitization was applied. Successful desensitization was achieved in three of the patients, allowing them to continue therapy without adverse reactions. Improvements in asthma control were observed post-desensitization, leading to the reduced need for systemic steroid treatments and an increase in quality of life. Conclusions: This study highlights the importance of recognizing hypersensitivity reactions to biologicals to have an appropriate approach for patients with severe asthma. As an effective approach for patients experiencing hypersensitivity reactions to biological agents, desensitization allows treatment continuation.
Language	English
Publishing date	2023-11-21
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines11123108
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Article ; Online: COVID-19 “Nightmare”

Maria Victoria Ruta / Teodora Alexescu / Doina Adina Todea / Nicoleta Stefania Motoc / Octavia Luiza Necrelescu / Andrada Urda Campean / Claudia Toma / Catalina Angela Crisan / Milena Adina Man

Journal of Personalized Medicine, Vol 13, Iss 12, p

Perceived Stress, Emotional Distress, and Burnout Syndrome among Medical Staff after One Year of the COVID-19 Pandemic

2023 Volume 1640

Abstract: 1) After one year of treating patients with SARS-CoV-2 infection, physical exhaustion is added to emotional stress and burnout syndrome. (2) By applying specific questionnaires, we evaluated healthcare workers who handled patients infected with SARS-CoV- ...

Abstract	(1) After one year of treating patients with SARS-CoV-2 infection, physical exhaustion is added to emotional stress and burnout syndrome. (2) By applying specific questionnaires, we evaluated healthcare workers who handled patients infected with SARS-CoV-2in terms of disease perception, perceived stress, emotional distress, and burnout syndrome after one year of the COVID-19 pandemic and compared them with staff who did not handle infected patients. (3) A total of 165 persons were evaluated, with 79 working in the COVID-19 department and 86 working in the non-COVID-19 department. No statistically significant differences were found in the perceived stress scores, emotional distress (functional or dysfunctional), and disease perception among the COVID-19 and non-COVID-19 groups. Also, we did not find any differences between the COVID-19 and non-COVID-19 departments concerning their total Maslach scores—50 in the COVID-19 department and 51 in the non-COVID-19 department, p = 0480—so a moderate level of burnout in the two groups. The only statistical difference was in the Maslach depersonalization scores, which were higher among COVID-19 workers ( p = 0.024). (4) In our center, there was no statistically significant difference in perceived stress or emotional distress. The level of burnout syndrome seems to be the same among the two groups, regardless if they worked withCOVID-19-infected patients or not.
Keywords	COVID-19 ; burnout syndrome ; emotional distress ; disease perception ; Medicine ; R
Subject code	150
Language	English
Publishing date	2023-11-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Alveolar proteinosis - an underdiagnosed condition in young people.

Chiş, Ana Florica / Man, Milena Adina / Chiş, Bogdan Augustin / Pop, Carmen Monica

Medicine and pharmacy reports

2021 Volume 94, Issue Suppl No 1, Page(s) S40–S42

Abstract: Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by an abnormal intra-alveolar accumulation of surfactant derived lipoproteinaceous compounds, leading to dyspnea and, in severe cases, to respiratory failure. The most common form ... ...

Abstract	Pulmonary alveolar proteinosis (PAP) is a rare lung disease characterized by an abnormal intra-alveolar accumulation of surfactant derived lipoproteinaceous compounds, leading to dyspnea and, in severe cases, to respiratory failure. The most common form of PAP is the auto-immune one. Secondary PAP has been recognized in myeloid leukemia, non-hematological neoplasms, lung infections or environmental exposure to noxious particles. Mutations in several genes (such as MARS, SFTPB, TTF1) are responsible for the alteration of surfactant production. Diagnosis tools include high-resolution computed tomography, bronchoalveolar lavage. Although over the past 20 years the pathophysiology of PAP has become more clear, the therapeutic strategies still need improvement. A national programme for patients with PAP might be useful in Romania.
Language	English
Publishing date	2021-08-10
Publishing country	Romania
Document type	Journal Article
ZDB-ID	2974425-8
ISSN	2668-0572 ; 2602-0807
ISSN (online)	2668-0572
ISSN	2602-0807
DOI	10.15386/mpr-2227
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Article: COVID-19 "Nightmare": Perceived Stress, Emotional Distress, and Burnout Syndrome among Medical Staff after One Year of the COVID-19 Pandemic.

Ruta, Maria Victoria / Alexescu, Teodora / Todea, Doina Adina / Motoc, Nicoleta Stefania / Necrelescu, Octavia Luiza / Campean, Andrada Urda / Toma, Claudia / Crisan, Catalina Angela / Man, Milena Adina

Journal of personalized medicine

2023 Volume 13, Issue 12

Abstract	(1) After one year of treating patients with SARS-CoV-2 infection, physical exhaustion is added to emotional stress and burnout syndrome. (2) By applying specific questionnaires, we evaluated healthcare workers who handled patients infected with SARS-CoV-2in terms of disease perception, perceived stress, emotional distress, and burnout syndrome after one year of the COVID-19 pandemic and compared them with staff who did not handle infected patients. (3) A total of 165 persons were evaluated, with 79 working in the COVID-19 department and 86 working in the non-COVID-19 department. No statistically significant differences were found in the perceived stress scores, emotional distress (functional or dysfunctional), and disease perception among the COVID-19 and non-COVID-19 groups. Also, we did not find any differences between the COVID-19 and non-COVID-19 departments concerning their total Maslach scores-50 in the COVID-19 department and 51 in the non-COVID-19 department,
Language	English
Publishing date	2023-11-24
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662248-8
ISSN	2075-4426
ISSN	2075-4426
DOI	10.3390/jpm13121640
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Article ; Online: Lung Microbiota in Idiopathic Pulmonary Fibrosis, Hypersensitivity Pneumonitis, and Unclassified Interstitial Lung Diseases

Milena Adina Man / Rodica Ana Ungur / Nicoleta Stefania Motoc / Laura Ancuta Pop / Ioana Berindan-Neagoe / Victoria Maria Ruta

Diagnostics, Vol 13, Iss 3157, p

A Preliminary Pilot Study

2023 Volume 3157

Abstract	(1) Introduction: Although historically, the lung has been considered a sterile organ, recent studies through 16S rRNA gene sequencing have identified a substantial number of microorganisms. The human microbiome has been considered an “essential organ,” carrying about 150 times more information (genes) than are found in the entire human genome. The purpose of the present study is to characterize and compare the microbiome in three different interstitial lung diseases: idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis, and nondifferential interstitial lung disease. (2) Material and methods: This was a prospective cohort study where the DNA of 28 patients with ILD was extracted from the lavage and then processed using the standard technique of 16S RNA gene sequencing. In a tertiary teaching hospital in the northern, western part of Romania, samples were collected through bronchoscopy and then processed. (3) Results: The same four species were found in all the patients but in different quantities and compositions: Firmicutes , Actinobacteria , Proteobacteria and Bacteroides . Streptococcus was the most prevalent genus, followed by Staphylococcus and Prevotella . Statistically significant differences in the OUT count for the ten most abundant taxa were found for the genus: Gemella , Actinobacteria , Prevotella , Neisseria, Haemophilus , and Bifidobacterium . The comparative analysis showed a richer microbiota in patients with IPF, as shown by the alpha diversity index. (4) Conclusions: In interstitial lung diseases, the microorganisms normally found in the lung are reduced to a restricted flora dominated by the Firmicutes family. These changes significantly disrupt the continuity of the observed bacterial pattern from the oropharynx to the bronchial tree and lung, possibly impacting the evolution and severity of interstitial lung diseases.
Keywords	interstitial lung disease ; lung microbiome ; lung microbiota ; idiopathic pulmonary fibrosis ; hypersensitivity pneumonitis ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2023-10-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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

Rajnoveanu, Armand-Gabriel / Rajnoveanu, Ruxandra-Mioara / Motoc, Nicoleta Stefania / Postolache, Paraschiva / Gusetu, Gabriel / Man, Milena Adina

Medicina (Kaunas, Lithuania)

2022 Volume 58, Issue 2

Abstract: 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 ... ...

Abstract	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.
MeSH term(s)	Firefighters ; Humans ; Occupational Diseases ; Occupational Exposure/adverse effects ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Pulmonary Disease, Chronic Obstructive/etiology ; Smoke
Chemical Substances	Smoke
Language	English
Publishing date	2022-02-05
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2188113-3
ISSN	1648-9144 ; 1010-660X
ISSN (online)	1648-9144
ISSN	1010-660X
DOI	10.3390/medicina58020239
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Article ; Online: A gyulladásos biomarkerek profilja SARS-CoV-2-fertőzésben szenvedő betegekben: mennyire tükrözik a tüdőérintettséget?

Mitrea, Adriana / Postolache, Parascheva / Man, Milena Adina / Motoc, Nicoleta Stefania / Sárközi, Hédi-Katalin / Dumea, Elena / Zamfir, Viorica / Dantes, Elena

Orvosi hetilap

2023 Volume 164, Issue 41, Page(s) 1607–1615

Abstract: Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with inflammatory and imaging alterations that vary depending on the disease severity.: Objective: Monitoring changes in inflammatory biomarkers may ... ...

Title translation	The profile of serum inflammatory biomarkers in patients with SARS-CoV-2 infection: how well do they reflect the presence of pulmonary involvement?
Abstract	Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with inflammatory and imaging alterations that vary depending on the disease severity. Objective: Monitoring changes in inflammatory biomarkers may offer insights into the extent of pulmonary alterations observed in chest-CT. This study aimed to evaluate the profile of different inflammatory biomarkers, widely available and routinely measured in COVID-19 patients, and to determine whether alterations in their activity at admission and discharge correlate with lung involvement assessed through CT scans. Methods: We conducted a retrospective observational study, wherein chest-CT scans were performed upon admission, and blood tests were conducted at admission and discharge. Treatment and monitoring adhered to national and international guidelines. Results: The profile of serum inflammatory markers (including values at admission and discharge, as well as their evolution during hospitalization) demonstrated a correlation with lung involvement as assessed by the total severity score. The high activity of serum inflammatory markers upon admission, accompanied by minimal changes during hospitalization, indicated a severe form of COVID-19 with notable lung involvement. While statistically significant differences were observed in C-reactive protein, fibrinogen, erythrocyte sedimentation rate, lactate dehydrogenase, and neutrophil-to-lymphocyte ratio, C-reactive protein emerged as the most reliable marker for assessing pulmonary involvement. Conclusion: Changes in serum inflammatory markers during hospitalization exhibited a weak to moderate negative correlation with the severity of lung involvement. Orv Hetil. 2023; 164(41): 1607-1615.
MeSH term(s)	Humans ; COVID-19/complications ; SARS-CoV-2 ; C-Reactive Protein ; Lung/diagnostic imaging ; Biomarkers ; Retrospective Studies
Chemical Substances	C-Reactive Protein (9007-41-4) ; Biomarkers
Language	Hungarian
Publishing date	2023-10-15
Publishing country	Hungary
Document type	Observational Study ; English Abstract ; Journal Article
ZDB-ID	123879-6
ISSN	1788-6120 ; 0030-6002
ISSN (online)	1788-6120
ISSN	0030-6002
DOI	10.1556/650.2023.32880
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