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(1) Background: Immunization of pregnant women (PWs) against Bordetella pertussis infection is still a challenging health matter. (2) Methods: We gathered questionnaire data from 180 PWs regarding their expectancies and current opinion on infectious disease prevention. For the group of PWs who agreed to further investigations, the serum levels of Ig G anti-B. pertussis antibodies (IgG-PT) titer were measured and analyzed. (3) Results: A total of 180 PWs completed the questionnaire and 98 (54.44%, study group) accepted to perform the laboratory tests. During the first two pregnancy trimesters, PWs were found to be more willing (compared with the control group) to test for identifying high-risk situations that could affect themselves and their future infant (p < 0.001). Most of the participating PWs (91, 91.9%) had low levels of anti-pertussis antibodies (values < 40 IU/mL). Declared vaccine coverage of the PWs newborn infants for DTaP-1 and Prevenar 13 (at 2 months) and DTaP-2 and Prevenar 13 (at 4 months) vaccination reached 100% in the study group, while in the control group only 30/82 (36.59%) PWs accepted to be vaccinated during pregnancy, none of them providing data on their infants' vaccine coverage. (4) Conclusions: Enrolled PWs faced a waning immunity against the B. pertussis infection. By raising maternal confidence in the protective role of vaccines against infectious diseases, better vaccine acceptance and better infant vaccine coverage can be achieved. [ABSTRACT FROM AUTHOR]

Pulmonary hypertension (PH) defines an increase in mean pulmonary arterial pressure (PAPm) at a value equal to or greater than 25 mmHg, determined invasively by right cardiac catheterization. The hemodynamic definition of PH considers the combination of different hemodynamic parameters: mPAP, pulmonary wedge pressure (PWP), cardiac output (CO), diastolic pressure gradient (DPG) and pulmonary vascular resistance (PVR). The clinical correspondence of the haemodynamic definition, considering both the pathological aspect and the therapeutic approach, classifies the clinical conditions that associate PH in five clinical groups. Worldwide data on the incidence of pulmonary hypertension are not systematically reported; data on PH prevalence in different aetiologies are not published in detail. PH epidemiology documentation becomes necessary in order to standardize diagnostic and therapeutic management practices, with particular interest in aligning the differences between different regions of the world, not only geographically but also economically. The only data on the survival rate of PH patients in Eastern Europe are published from the Czech Republic registry. The better survival in the thromboembolic PH subgroup may be positively influenced by the availability of specific pharmacological therapy since 2007. The Portuguese registry reported in 2017 a survival rate at 1, 3 or 5 years of 95%, 77% and 71%, respectively, for new cases with different PH aetiologies, and the absence of statistically significant differences between different aetiology groups, but with a better prognosis for congenital heart disease related PH cases. For Romania, the National Pulmonary Hypertension Register has centralized the data from the six national diagnostic and treatment centres by 2017. The PH pathophysiology is based on pulmonary vascular remodelling by endothelial cell proliferation, smooth muscle cell hypertrophy and perivascular inflammation. [ABSTRACT FROM AUTHOR]

Introduction: Chronic thromboembolic pulmonary hypertension (CTEPH) is a disease in which a pulmonary artery is occluded with a thrombus. This increases pulmonary resistance and, therefore, the afterload of the right heart, resulting in pulmonary hypertension. Balloon pulmonary angioplasty is a minimally invasive procedure to dilate stenosed pulmonary arteries, such as those in patients with CTEPH. During this procedure, a balloon catheter is inserted through a central vein from the right heart to the pulmonary arteries. At the site of stenosis, the balloon is inflated and dilates the stenotic material so that the arteries are open and perfusion is ensured. Case Report: With restricted availability in Romania due to a lack of expert centres, we present the case of a 49-y.o. patient, known with bilateral PE post episode of right femoral-popliteal DVT, under anticoagulant therapy with Warfarin, later diagnosed with pulmonary hypertension group 4 (subgroup 4.1) WHO-functional class III and thrombophilia (A1298C MTHFR gene heterozygous mutation). At the presentation (2019), an electrocardiogram showed sinus rhythm, right axis deviation with right bundle branch block, and signs of atrial and ventricular hypertrophy. Echocardiography and right heart catheterization presented signs of severe pulmonary hypertension. Mean NTproBNP values before PEA were above 4000 pg/mL, and the 6-minute walking distance(6MWD) measured 79% from predicted. The patient underwent specific national treatment with guanylate cyclase stimulator (indication IA European Guide ESC/ERS 2022) - total daily dose 3x2.5mg. Discussions : BPA improves the life expectancy and quality of the patients with access to this procedure. They can reduce or quit their medication, which will also reduce side effects and increase life quality. In May 2023, under collaboration with experts from Poland PH's interventional centre, the patient underwent BPA at the level of the inferior right pulmonary lobe. Assessment after one year showed an improvement of 7% in 6MWD and minimal signs of myocardial stress, as represented by NTproBNP values of 48 pg/mL. Conclusions: Balloon pulmonary angioplasty is a feasible interventional method in inoperable CTEPH, improving hemodynamic parameters, proper heart function, and exercise capacity. [ABSTRACT FROM AUTHOR]

Women in rural Romania face significant health disadvantages. This qualitative pilot study describes the structural disadvantage experienced during pregnancy by women in rural Romania, focusing on the lived experiences of Roma women. We explore how women in rural communities experience pregnancy, their interactions with the healthcare system, and the role that ethnic and social factors play in pregnancy and childbearing. We conducted 42 semi-structured interviews with health and other professionals, seven narrative interviews with Roma and non-Roma women and a focus group with Roma women. Data were analysed using thematic analysis. We identified intersectional factors associated with women's pregnancy experiences: women perceiving pregnancy as both unplanned and wanted, joyful, and normal; women's and professionals' differing prenatal care perceptions; transport and cost related barriers to care; socioeconomic and ethnic discrimination; and facilitators to care such as social support, having a health mediator and having a doctor. Talking directly with professionals and Roma and non-Roma women helped us understand these many factors, how they are interconnected, and how we can work towards improving the pregnancy experiences of Roma women in rural Romania. [ABSTRACT FROM AUTHOR]

Background: Pulmonary hypertension (PH) is a progressive disease in which the mean pulmonary arterial pressure is greater than 20 mmHg. There are 5 main groups explaining the underlying cause of the disease: 1 - pulmonary arterial hypertension; 2- left heart disease; 3- pulmonary disease; 4- chronic pulmonary thromboembolism; and 5- multifactorial pathology. The Reveal Lite 2 score is used to assess patients' risk for 1 year mortality. Objective: This study aims to assess risk in patients depending on their age, pulmonary hypertension group and functional class, and Reveal Lite 2 score. Material and methods: We designed a retrospective, observational study, on 65 patients from 2016 to 2023. All the patients included in the study were diagnosed with pulmonary hypertension and were being monitored and using targeted medical therapy in the Internal Medicine II - Cardiology Department, Emergency Clinical County Hospital of Targu Mures. Results : Patients' data were computed according to their etiology. In PH group 1.1, the mean age is 59,87 y.o., +/-SD of 14,07 years, the mean functional class is 2,366 and the Reveal Lite 2 mean is 6,155; in PH group 1.2, the mean age is 48,33 y.o., +/-SD of 9,56 years, the mean functional class is 2 and the Reveal Lite mean is 4,33; in PH group 1.4.1, the mean age is 54,86 y.o., +/-SD of 6,5 years, the mean functional class is 2,85 and the Reveal Lite 2 mean is 7; in PH group 1.4.4, the mean age is 35,93 y.o., +/-SD 15,65 years, the mean functional class is 2,153 and the Reveal Lite 2 mean is 5,441; in PH group 4.1, the mean age is 62,95 y.o., +/-SD 9,963 years, the mean functional class is 2,42 and the Reveal Lite 2 mean is 7,26. Preliminary statistical analysis showed a statistically significant difference between Reveal Lite 2 scores calculated for each group (p <0,0001). Conclusions: Different PH groups have different predictions of risk based on etiologic factors. Further analysis will determine if these findings correlate with the TAPSE/PASP ratio, an echocardiographic parameter which has been previously used to predict pulmonary hypertension prognosis in patients. [ABSTRACT FROM AUTHOR]

Background and objectives. The use of affordable and simple tools to identify patients with severe forms of COVID-19 is imperative worldwide. The aim of the present study was to identify factors associated with the unfavourable progression of SARS-CoV-2 infection in the Military Emergency Clinical Hospital “Dr. Victor Popescu”, Romania. Materials and methods. Data from 166 patients admitted with a positive SARS-CoV-2 reverse transcription-quantitative PCR test were retrospectively collected. The presence of lung changes on chest X-ray scans was the criterion used to divide the subjects into two groups: patients with no radiological findings (group 1; n=45) and patients with radiological features of pneumonia (group 2; n=121). Results. The mean age (P<0.0001) and body mass index (P=0.0109) were significantly higher in group 2 compared with group 1. Ageusia and headache, as clinical manifestations of COVID-19, were significantly prevalent (P=0.005 and P=0.007, respectively) in group 2; in the same group, cardiovascular risk factors and established cardiovascular disease were highly prevalent. In SARS-CoV-2 patients with radiological lung changes, correlations were identified between neutrophil-to-lymphocyte ratio (NLR), and C-reactive protein (P<0.001; CI 95%, 0.137-0.471) and fibrinogen (P=0.009; CI 95%, 0.054-0.406), respectively. Only the platelet-to-lymphocyte ratio (PLR) was identified as a marker of X-ray changes (P=0.029). Within group 2, and for patients with unfavourable disease progression, the NLR were significantly correlated with intensive care unit admission (P<0.0001) and were highly correlated with mortality (P=0.001). Increased lactate dehydrogenase (LDH) values had the same tendency. Conclusions. An unfavourable progression of SARS-CoV-2 infection can be expected in middle-aged, obese patients, and in those with elevated levels of inflammatory markers and LDH. Abnormally increased NLR and PLR values may also serve as potential indicators of disease severity; however, further evaluation in a larger patient sample is required to determine the predictive role of these rations in SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

Objectives. The present study aims to describe the clinical and biological profile of heart failure patients from central Romania. Material and method. A single centre-based retrospective, observational, descriptive study involving heart failure patients admitted from January 2018 to March 2020 was conducted. Only patients who had echocardiographic data determined by the same examiner were included. Patients were classified according to LVEF at admission in three subgroups: preserved LVEF subgroup (HFpEF, LVEF ≥ 50%), moderate LVEF subgroup (HFmrEF, LVEF 40-49%), reduced LVEF subgroup (HFrEF, LVEF < 40%) and their clinical and biological profile was assessed. Comorbidities were recorded using the Charlson comorbidity index (CCI). Outcomes. A total of 175 patients (57.7% males) were included in our study, with a mean age of 65.3 ± 11.7 years. 44% of patients had more than one hospital admission during the studied timeframe. Mean calculated left ventricular ejection fraction was 47.1% ± 12.1%. According to LVEF 62.8% of patients were in HFpEF group, 20.5% in the HFrEF group and 16.5% in the HFmrEF group. Dyspnoea was the most common presenting symptom in 65.7% of patients, being accompanied by fatigue in majority of cases (63.4%). Charlson comorbidity index mean value for the study population was 4.6 ± 2.1, 4.6 ± 2 in the HFpEF group, 5.2 ± 1.9 in the HFmrEF group and 4.03 ± 2.2 in the HFrEF group. Arterial hypertension was the most frequent comorbid condition and risk factor at the same time, in both men and women. Conclusions. The clinical and biological profile of the heart failure patients is complex, diverse and further research is needed for improving therapeutic and follow-up management of these patients. [ABSTRACT FROM AUTHOR]