Background: Obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) are prevalent conditions with overlapping clinical features and shared consequences on autonomic function. Heart rate variability (HRV), a non-invasive biomarker of autonomic nervous system activity, may offer diagnostic, prognostic, and therapeutic insights in this patient population. Methods: A comprehensive literature review was conducted using PubMed, Google Scholar, and MEDLINE to identify peer-reviewed English-language studies published between January 2015 and December 2024. Studies were included if they evaluated HRV parameters in individuals with OSA, COPD, or overlap syndrome, explored HRV as a marker of disease severity or progression. A total of 239 studies were identified; after screening, 41 met the inclusion criteria. Results: The analysis revealed consistent evidence linking reduced HRV with both OSA and COPD severity. HRV alterations were more pronounced in overlap syndrome, reflecting synergistic autonomic dysfunction. HRV showed potential in differentiating disease stages, predicting cardiovascular risk, and evaluating treatment efficacy, particularly for CPAP therapy in OSA. Short-term HRV was particularly sensitive to autonomic changes, while long-term recordings helped track disease progression. Emerging evidence supports the use of HRV derived from wearable technologies as a viable screening tool for health and wellness. Conclusion: HRV is a valuable, non-invasive tool for assessing autonomic dysfunction in OSA, COPD, and their overlap. It offers significant potential for early diagnosis, disease monitoring, and treatment evaluation. Integrating HRV into clinical practice, could enhance diagnostic efficiency, reduce healthcare burden, and improve outcomes in high-risk respiratory populations. Furthermore, longitudinal studies are warranted to standardise HRV thresholds and validate their use in routine screening protocols.

Background: Asthma is a chronic inflammatory airway disease in which oxidative stress and antioxidant imbalance play a critical role in disease progression and therapeutic response. This study aimed to evaluate oxidative stress and antioxidant status in relation to asthma control levels. Methods: A total of 106 patients admitted to the Clinical Hospital of Pulmonary Diseases, Iași, between March and May 2024 were included in this study. Patients were classified into three groups based on asthma control: well-controlled (AB-TCG), partially controlled (AB-PCG), and uncontrolled asthma (AB-UCG). Demographic, biochemical, and hematological parameters were assessed, with attention to oxidative stress markers and antioxidant defenses. Results: The study population was predominantly female (75%), with a mean age ranging from 50.75 to 64.38 years, and the majority residing in rural areas (73–75%). The AB-UCG group showed significantly elevated inflammatory markers, including a white blood cell count of 9.33 × 10³/µL (p = 0.005) and eosinophil percentage of 4.20% (p = 0.03), compared with the other groups. This group also exhibited an unfavorable lipid profile, with increased total cholesterol (207.40 mg/dL) and triglyceride levels (157.21 mg/dL). Oxidative stress was notably higher in the AB-UCG group, as indicated by elevated malondialdehyde (MDA) levels (2.86 mmol/L) versus 2.35 mmol/L in the AB-PCG group (p < 0.005), along with decreased serum uric acid (4.64 mg/dL) and reduced glutathione (GSH) levels (275.41 µmol/L), leading to a lower GSH/GSSG ratio. Environmental exposures, including tobacco smoke and occupational chemicals, were associated with exacerbated oxidative imbalance. Conclusions: The findings highlight the critical involvement of oxidative stress and compromised antioxidant defenses in poorly controlled asthma. Biomarkers such as MDA, white blood cell count, eosinophil percentage, and the GSH/GSSG ratio may act as valuable tools for personalized asthma management and therapeutic monitoring.

Regular and unobstructed breathing during the night is the prerequisite for an undisturbed and restful sleep. The most prevalent nocturnal breathing disturbance with morbid consequences is obstructive sleep apnea syndrome. The prevalence of obstructive sleep apnea (OSA) is increasing, and a significant number of patients with OSA are undiagnosed. On the other hand, the “obesity epidemic” is a growing concern globally. A sleep test is required to diagnose sleep apnea and to individualize therapy. A multidisciplinary approach is the key to success. This narrative review presents a debate on whether surgery is a friend or a foe in the treatment of sleep apnea. Depending on the type and severity of the apnea, the causal factor, and the presence of obesity and hypercapnia as well as the associated pathologies, the optimal therapeutic method is determined for each individual case. The article concludes that each case is unique, and there is no ideal method. Positive pressure ventilation, although a therapeutic gold standard, has its disadvantages extensively discussed in this paper. Nevertheless, it is necessary prior to any surgical intervention, either for the curative treatment of the causal factor of apnea or for elective surgery for another condition. The anesthetic risks associated with the presence of apnea and obesity should not be neglected and should form the basis for decision making regarding surgical interventions for the treatment of sleep apnea.

Limited data exist on the underlying physiological phenomena of aerobic training; the impulse oscillometry method, allowing the assessment of small airways and lung periphery in addition to standard lung function testing, might be a useful addition to rehabilitation programs. Background/Objectives: This study aimed to determine the immediate effect of a structured low-intensity aerobic training program on small airway function in healthy volunteers to explore potential implications for long-term COPD care. Methods: Thirty-six healthy volunteers were recruited between May 2024 and January 2025; each participant underwent a lung function testing session, followed by low/moderate-intensity aerobic exercise, and, after 15 min, by a second impulse oscillometry assessment. Results: There was a statistically significant reduction in airway resistance following the physical exertion for the whole group (mean difference 0.03 kPa/L/s, 95%CI 0–0.6 kPa/L/s); significantly lower values were recorded for the reactance component X5 (0.02 kPa/L/s, 95%CI 0–0.4 kPa/L/s) for the normal weight subgoup (n = 24). These results, corroborated with literature data, suggest optimization of the distribution of the airflow and possibly alteration of the elastic properties of the thoracic structures following even low-intensity effort. Conclusions: Low-intensity upper body strength and aerobic training seem to have an immediate respiratory beneficial effect on healthy volunteers manifested as a reduction in airway resistance. The underlying mechanism might be related to improved contractility of respiratory muscles, but changes in lung parenchyma elasticity may also be involved, possibly reflecting modifications of ventilation heterogeneity. Impulse oscillometry may be superior to spirometry in monitoring the effects of aerobic training, considering the additional data it provides, and could be used to optimize and personalize rehabilitation protocols.

In recent decades, the burden of TB has been gradually declining; however, with the emergence of COVID-19 and ongoing political conflicts, including the war in Ukraine, the proper functioning of healthcare services and TB control programs has been jeopardized. Recently, research has emphasized the importance of hematological parameters associated with inflammation, which can be easily analyzed through routine blood tests. Combining these parameters may have predictive value for various diseases, including pulmonary tuberculosis and even help monitor the effectiveness of treatment. Since there is no single hematological or inflammatory biomarker that provides precise and dynamic information about the success or failure of treatment, identifying individual markers or sets of biomarkers with higher sensitivity and specificity is essential. This is particularly important since sputum culture conversion at two months remains insufficiently sensitive and microscopy conversion has limited sensitivity and specificity in detecting treatment failure. Also, the analysis of the impact of the standard directly observed treatment, short-course regimen on pathogenic mechanisms also focuses on how it influences the interaction between inflammation and oxidative tissue degradation, by measuring plasma levels of glutathione. Utilizing a combination of hematological, inflammatory, and antioxidant biomarkers offers significant insights into systemic inflammatory responses in pulmonary tuberculosis patients, both before commencing treatment and during the entire duration of antituberculosis therapy. Combining different inflammatory parameters into a multiple biomarker can significantly enhance the accuracy of predicting prognosis and response to antibiotic chemotherapy. Identifying an optimal combination of biomarkers with predictive value is crucial for assessing treatment response and evaluating the effectiveness of anti-TB medication. Rather than developing or testing a composite prediction model, this review summarizes reported performance metrics from individual studies and highlights priorities for future prospective validation of integrated biomarker panels.

SARS-CoV-2 infection has disrupted healthcare services worldwide. Romania has registered difficulties in carrying out tuberculosis (TB) control activities. Aim: evaluation of anti-TB activity in Iasi County in pandemic conditions and its reflection in epidemiometric indicators. Material and method: comparative retrospective study performed on data on TB control in Iasi County, between 2019 and 2020 The analyzed indicators reflect the surveillance and control of the disease, the treatment of latent tuberculosis infection (LTBI), the management of TB cases. Results: compared to 2019, in 2020 there were 33.5% fewer consultations performed to detect cases of TB infection/disease, 5% fewer tests for detection of LTBI, 50.7% fewer Mt bacteriological investigations and 39.7% fewer epidemiological investigations. The number of treated patients decreased by 1/4 in 2020 compared to 2019. The decrease of medical services is reflected in reduction in the global incidence by 40.5%; however, in the same periods, the incidence of TB in children did not register significant differences - 15.94% 000 versus 15.93% 000 sugesting an ongoing TB epidemic. Conclusions: • TB management in Iasi County recorded significant qualitative and quantitative deficiences during the SARS-CoV-2 infection; • The important drop of global incidence does not reflect the reality of the epidemiological process, as there is a stagnation in the incidence of childhood TB; • The experience of the last year shows that inventiveness and flexibility are needed in the management of TB in pandemic conditions.