In this observational cohort study, sleep quality in post-COVID-19 patients was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. This study aimed to examine aspects of sleep quality in patients who have undergone SARS-CoV-2 infection and if there is a pattern of progression or regression over time (6 months). We also observed and analyzed the results in order to identify any possible links between the severity of COVID-19 and sleep quality as measured by the PSQI questionnaire. The study group consisted of 65 adult patients with confirmed SARS-CoV-2 infection who were referred to a pulmonologist for evaluation. Sleep quality was impacted at a high rate in post-COVID-19 patients, quantified by a PSQI score ≥5. Out of 65 patients, 51% of them had scores greater than or equal to 5. Sleep was subjectively reported as unsatisfactory predominantly in mild and moderate COVID-19 patients. According to the PSQI score and a 6-month follow-up, many patients presented persistency in poor sleep quality. Investigation and individualized treatment of sleep disorders in post-COVID-19 patients should be part of the routine pneumological control, as improvement in sleep quality has an impact not only on the health but also on the psychological state of patients. Educating patients about the importance of sleep and sleep quality impairment should be a primary concern.

Introduction: Tuberculosis (TB) remains a global health challenge, requiring enhanced active case finding (ACF) through screening strategies. This study assesses the effectiveness of such an approach in locating TB cases among vulnerable groups, such as homeless persons, injecting drug users, those detained in prison, and people living in rural areas. Methods: The study focuses on socio-economic characteristics and TB detection rates across Romanian counties using modern techniques including computer-aided detection of lesions on chest X-ray and GeneXpert tests. Results: The results highlight the disproportionate burden of TB in vulnerable groups, by revealing significant differences in TB detection rates between regions. Notably, the TB detection rates among these vulnerable groups (250.85 per 100,000 population) are five times higher than the national incidence rate (46.1). Discussion: These findings underscore the imperative integration of ACF into National TB Program to provide customized and efficient solutions for diverse vulnerable groups, thereby informing crucial public health initiatives and interventions.

The article analyzes the effects of psychosocial interventions on adherence to tuberculosis (TB) treatment among vulnerable populations in Romania. The study includes 4104 patients from disadvantaged groups (rural, injecting drug users, homeless), beneficiaries of a national multidisciplinary support program. Multivariate analyses conducted on drug-susceptible TB (DS-TB) patients within this cohort identified some predictors of therapeutic success, such as extrapulmonary diagnosis, peer-to-peer educational support, and a higher level of education. At the same time, men, occupationally inactive people and those in the initial phase of treatment at project entry showed lower adherence. The results support the integration of psychosocial interventions in TB management.

Short wavelenght light (blue light) contributes to dysregulations of the circadian cycles. In an era where most of the light sources were replaced by Light Emitting Diodes (LEDs), a new problem regarding sleep quality and nictemeral cycle appears. Even though blue light is currently being used a treatment for sleep dysregulations and insomnia (through cycle altering), this stimuli activates the melanopsin secretory mechanism via photoreceptor cells and thus supresses the pineal secretion of melatonin. Melatonin plays a crucial role in provoking pre-sleep symptoms, inducing and maintaining sleep, improving sleep quality and multiple other effects dependant to the organ, such as being an antioxidant or its protective atribute against diabetes. This paper is a general review of the literature and brings to a single place multiple studies about the importance of sleep, physiology of melatonin secretion and the effect of light exposure on those aforementioned.

Reversing the concept of the Romanian medical system in terms of approaching patients with tuberculosis (TB) and removing them from a hospital-centred system into a more friendly outpatient system, closer to their needs, is one of its challenges. Preliminary data of this project show that through minimal and consistent investments the diagnosis, treatment and monitorisation can be made exclusively in the outpatient department for these patients.

Background: Tuberculosis (TB) remains one of the most globally impactful infectious diseases, with a recorded mortality of 1.6 million in 2022. In Romania and Ukraine, two high burden countries in the context of the WHO European region, treatment is geared towards cure; however, this path is paved with significant challenges, from morbidity to loss to follow-up. Methods: A retrospective study was performed for drug-susceptible TB patients hospitalised in three TB expertise centres in Romania and Ukraine using routinely collected data. Univariable and multivariable logistic regression analyses were used to assess predictors of three treatment outcomes: unfavourable outcomes, loss to follow-up, and death. Results: A total of 838 patients diagnosed with drug-susceptible TB were included. Median hospitalisation was 39 days (IQR 25–67), and treatment duration was 7 months (IQR 6–8). Predictive variables differed by outcome. For unfavourable outcomes, the multivariable model included age > 65 years, chronic kidney disease, at least one cavity on chest X-ray, underweight status, and persistently abnormal laboratory parameters despite intervention. Independent predictors of loss to follow-up were alcohol use, COPD, TB infection within two years prior to admission, obesity, slow treatment response, and sputum microscopy ≥2 + . Predictors of death included age > 65 years, male sex, cirrhosis, chronic kidney disease, underweight status, persistently abnormal laboratory parameters, and slow treatment response. Conclusion: Contextualising factors influencing drug-susceptible TB treatment outcomes in different settings can support the development of tailored interventions that enable early identification of patients at higher risk, thereby avoiding unnecessary treatment effects.