Papers by Dragos Bumbacea
American Journal of Respiratory and Critical Care Medicine, 2014
Clinical and Translational Allergy
Lung cancer, as the leading cause of death in oncology is one of the most challenging diseases no... more Lung cancer, as the leading cause of death in oncology is one of the most challenging diseases nowadays. Even after the implementation of checkpoint inhibitors and targeted therapy as a standard of therapy for metastatic disease, the chemotherapy backbone remains essential in the treatment of these patients. This study aimed to evaluate how administration particularities in chemotherapy and toxicity management can influence the outcome. We conducted a retrospective single-institution study, at Elias University Emergency Hospital, Bucharest, Romania, between 2014 and 2018, in a heterogeneous patient population with metastatic non-small cell lung cancer that received combination chemotherapy. The inclusion criteria for this trial were—histological proof of non-small cell lung cancer (NSCLC), stage IV disease, ECOG (Eastern Cooperative Oncology Group) performance status of a maximum of two, treatment with cytotoxic chemotherapy for at least four courses (patients with fewer courses wer...
European Respiratory Journal, 2020
European Respiratory Journal, 2011
Background: Patients with COPD have severe breathlessness induced by the increased mechanical wor... more 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...
Introduction:Chronic obstructive pulmonary disease (COPD) is a global health problem resulting in... more Introduction:Chronic obstructive pulmonary disease (COPD) is a global health problem resulting in significant morbidity. Acute exacerbation of COPD (AECOPD) is a severe complication associated with increased short- and long-term mortality. Identifying predictors of long-term mortality after a severe AECOPD may improve management and long-term outcome of this disease. Materials and methods:A two-year prospective cohort study was undertaken in an academical medical center between 2016 and 2018. Patients with severe AECOPD who required non-invasive ventilation (NIV) were included. Baseline characteristics at inclusion, comorbidities (kidney dysfunction, left heart disease, diabetes), number of prior episodes of AECOPD and indication for long-term oxygen therapy (LTOT) or non-invasive ventilation (LTNIV) were recorded. Patients were monitored for a two-year period after initial admission. Outcomes were six-month, one-year and two-year mortality, irrespective of cause. Outcomes:51 patien...
European Respiratory Journal, 2014
Aim : To evaluate the outcome of non-invasive ventilation (NIV) for acute hypercapnic respiratory... more Aim : To evaluate the outcome of non-invasive ventilation (NIV) for acute hypercapnic respiratory failure in older patients. Methods : Consecutive patients presenting at the emergency room of a general hospital in 2012-2013 with acute hypercapnic respiratory failure and treated in the respiratory ward with NIV through an oronasal or full facial mask. Outcomes were compared in older (≥ 70 years old) vs younger patients. Results : 63 patients were included, 28 being 70 years old or older (OLD, age range 70-92) and 35 younger (YOU, age range 28-69). There was a non-significant tendency versus more women (61% vs 40%) and worse previous performance status score (2.8±1.0 vs 2.2±1.3) in older group. Initial blood gases results were similar, as were those after 4-6 hours of NIV and at discharge (see table, p>0.05 for all comparisons between groups), with significant improvements in PaCO2 and pH in both groups. There were no major differences in cause of respiratory failure (COPD exacerba...
Maedica, 2011
In a very intriguing study inhaled placebo and sham acupuncture had a similar effect on asthma sy... more In a very intriguing study inhaled placebo and sham acupuncture had a similar effect on asthma symptoms as inhaled salbutamol when compared with no intervention, despite a lack of effect on lung function measured by FEV1 (1). By showing again the magnitude of placebo effect in asthma this study re-emphasizes the need for a good choice of controls in asthma studies.
BACKGROUND : Pulmonary alveolar proteinosis (PAP) is a rare lung disease affecting the interstiti... more BACKGROUND : Pulmonary alveolar proteinosis (PAP) is a rare lung disease affecting the interstitium with an abnormal accumulation of surfactant within the alveoli that may affect gas exchange and can lead to dispneea and exercise limitation. AIM: The aim of this study was to analyse the relation bewteen exercise capacity and pulmonary lung function in a series of patients diagnosed with alveolar proteinosis. SUBJECTS AND METHOD : retrospective analysis of 7 consecutives cases of PAP diagnosed in our clinic. All patients performed, at the time of diagnostic, body pletismography: Total Lung Capacity (TLC), carbon monoxide diffusion capacity (DLCO), 6 minutes walking test (6MWT). RESULTS: 7 patients: 3 females / 4 males. The mean age was 45.5±15 years (range 22-73 years). All patients presented as major symptom dyspneea, with a mean 2.8±0.4 on mMRC scale. The functional pattern was restrictive, with decreased TLC 4%) was found in 5/7 cases. Mean oxyhemoglobin saturation (SaO2) at rest ...
Background: Respiratory muscle impairment could contribute to severe breathlessness and exercise ... more Background: Respiratory muscle impairment could contribute to severe breathlessness and exercise intolerance in COPD patients. Aim: To evaluate the respiratory muscle function and exercise tolerance in COPD patients before and after pulmonary rehabilitation. Subjects and methods: Respiratory muscle strength (maximal inspiratory pressure MIP, maximal expiratory pressure MEP), exercise tolerance (6 minutes walking test 6MWT) and dyspnoea score (BORG 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-two patients with COPD stage II-IV GOLD were included. Mean MIP value was 68.6% of the predicted value (less than 70% in 16 cases) and mean MEP value 104.4%. The mean 6MWT distance (6MWD) was 410 meters. 6MWD was better associated with MIP (r 0.62) than with MEP (r 0.38). Severity of dyspnoea was negatively associated with MIP values (r -0.4...
Aim: Assessing the frequency of relapses and the disease characteristics associated with relapses... more Aim: Assessing the frequency of relapses and the disease characteristics associated with relapses in corticosteroid treated sarcoidosis patients. Subjects and methods: 125 patients with biopsy-proven sarcoidosis treated with corticosteroids for 6-18 months after diagnosis were evaluated. Number and type of relapses were noted during the follow-up period. The clinical and laboratory parameters were compared in patients with a relapse of the disease versus (vs) patients without relapses. Results: 38 patients (30%) had a sarcoidosis relapse, 2-42 months after the treatment stop (mean interval 11±13 months). The manifestations were clinical in 36 patients (similar symptoms as at diagnosis), radiological in 34 and functional in 26 (decreased diffusion capacity in 22 patients, pulmonary volumes in 13 and flows in 15). The relapses were seen in 7 patients with complete remission after the first treatment, 30 with partial remission and 1 with stationary evolution. The patients with relapses...
The superior sensitivity of IFNγ release assays (IGRAs) in diagnosing LTBI above tuberculin skin ... more The superior sensitivity of IFNγ release assays (IGRAs) in diagnosing LTBI above tuberculin skin testing (TST) may be compromised by immunodeficiency. We performed direct comparisons between tests in immunocompromised patients. IGRAs (T-SPOT/QFT) and TST were performed and clinical data on drugs and TB exposure were collected. Interim results from 193 organ transplant patients and 204 patients with rheumatoid arthritis (RA) are presented. In transplant patients, 80% had results for all 3 tests, which were less often positive for TST (11.7%) than for T-SPOT (20.8%) and QFT (15.6%, p=0.018). Agreement was substantial between IGRAs (κ=0.61), and only fair between IGRAs and TST (κ=0.22, T-SPOT; 0.34, QFT). All 3 tests were more often negative despite TB risk factors in patients 3 immunomodulatory drugs. All tests in both groups were associated with TB-exposure without marked confounding by age, sex, number of drugs or time post transplant. Despite TB risk factors, results are more often negative in transplant patients in the first year post transplant and in RA patients with >3 immunomodulatory drugs, likely due to higher level of immunosuppression. This emphasises the need for LTBI screening prior to transplantation or immunosuppressive treatment to increase diagnostic accuracy.
Medicina
Background and Objectives: Patient’s behaviours, attitudes and beliefs related to asthma and its ... more Background and Objectives: Patient’s behaviours, attitudes and beliefs related to asthma and its treatment were shown to influence the adherence to therapy and the level of asthma control. This survey aimed to assess the level of asthma control and patient-reported behaviours, attitudes and expectations related to their disease in Romanian patients. Materials and Methods: This cross-sectional quantitative survey was performed in February-March 2019 and enrolled 70 specialist physicians experienced in asthma management and 433 asthma patients under their care. Results: Of the 433 patients enrolled, 19.4% had mild asthma, 60.5% moderate asthma and 20.1% severe asthma. For the previous 12 months, asthma symptoms, exacerbations and emergency room visits were common in the sample analysed, with significantly higher figures in severe asthma patients (p < 0.001). The most important treatment goal for asthma patients was participation in all activities of daily living, while for physicia...
High flow nasal therapy and respiratory muscles
Acute noninvasive ventilation
Noninvasive Ventilatory Support
European Respiratory Journal, Sep 1, 2013
European Respiratory Journal, Sep 1, 2013
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Papers by Dragos Bumbacea