Pulmonary complications are an important yet underappreciated aspect of inflammatory bowel disease (IBD), which includes Crohn’s disease (CD) and ulcerative colitis (UC). These conditions often manifest with extraintestinal symptoms that can significantly influence the clinical trajectory of the disease. Pulmonary involvement in IBD can range from mild symptoms, such as a persistent cough, to severe conditions, including interstitial lung disease or pulmonary embolism. This systematic review aims to assess the prevalence, clinical presentations, and implications of pulmonary involvement in IBD patients. A comprehensive literature search was conducted using PubMed database up to the 1st of May 2024. Inclusion criteria focused on studies involving adult IBD patients with documented pulmonary symptoms, evaluated through clinical, radiological, and histopathological approaches. Of the 463 studies identified, 27 met the inclusion criteria, consisting of 36,264 patients. Pulmonary manifestations were classified into airway diseases and parenchymal involvement. Airway diseases, including bronchiectasis and chronic bronchitis, were the most common, followed by parenchymal conditions such as organizing pneumonia and interstitial lung disease (ILD). Smoking was identified as a significant risk factor for pulmonary involvement. Pulmonary involvement in IBD is diverse and often underdiagnosed. Early recognition and management are crucial to improving patient outcomes.

Romania has a notification rate of 59.5 per 100,000 persons having a notification rate of 59.5 per 100,000 persons, with a continuous decreasing tendency. The pilot project of the Ministry of Health aims to avoid hospitalization for TB. The aim of the study were to evaluate the opinions of the ambulatory and hospital`s doctors as related to the outpatient TB treatment in correlation with the current medical infrastructure. At the same time, we also evaluated patients9 opinions on this aspect. Material and Method: A questionnaire were used, carried out specifically for doctors, nurses and patients. A total of 15 physicians, 25 nurses and 30 patients participated. Results: Pneumologists consider that a hospitalization period of at least 2 weeks is required at the beginning of anti-TB treatment. The current medical system does not meet the real needs to be able to carry out anti-TB treatment in outpatient setting (unavailable human resources, difficult daily travel to a hospital unit, fear of contagion of family members). 50% have a precarious social situation and cannot afford a proper hygienic diet and nutrition. Ethylism and smoking are risk factors for therapeutic abandonment in the same percentage. The vast majority of patients have little medical information about the disease they have and consider it appropriate to be admitted to a medical unit during treatment. The economic analysis carried out did not show a significant benefit if the hospitalization was avoided. Conclusions: The outpatient treatment model of TB appears to be unsuitable for the Romanian medical system, especially since the endemic level is still medium, even though it has dropped below 100%ooo new cases per year.

Background: Psychological distress is a common comorbidity in chronic obstructive pulmonary disease (COPD), yet its relationship with disease severity remains incompletely understood. This study aimed to assess depression, anxiety, and stress using the Depression Anxiety Stress Scales–21 (DASS-21) and to examine their distribution across COPD severity stages. Methods: This multicenter, cross-sectional observational study included 285 clinically stable COPD patients enrolled between 2023 and 2025. COPD severity was classified according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Multinomial and binary logistic regression models were constructed to identify independent predictors of COPD severity and clinically significant psychological distress, adjusting for demographic and clinical covariates. Bayesian independent sample analyses and ANOVA effect size estimates were additionally performed. Results: Smoking exposure was independently associated with advanced COPD stages (GOLD 4 vs. GOLD 1–3: aOR 1.05, p < 0.001), as was dyspnea severity (mMRC: aOR 14.66, p < 0.001). In multivariable models examining psychological outcomes, COPD severity was not independently associated with clinically significant depression (p = 0.899), anxiety (p = 0.460), or stress (p = 0.843). In contrast, symptom burden measured using the COPD Assessment Test (CAT) score was consistently associated with depression (aOR 1.133, p < 0.001), anxiety (aOR 1.179, p < 0.001), and stress (aOR 1.144, p < 0.001). ANOVA effect sizes across GOLD stages were small (η² ≤ 0.047), and Bayesian analyses provided moderate to strong evidence supporting minimal differences in DASS-21-R scores between severity groups. Conclusions: Psychological distress is prevalent across all COPD severity stages and is not independently determined by airflow limitation. Symptom burden rather than spirometric severity appears to be more closely associated with emotional outcomes.

Background: Chronic obstructive pulmonary disease (COPD) is frequently accompanied by psychological distress, but the relationship between GOLD stage, dyspnea, functional limitation, and depression/anxiety symptoms remains incompletely defined. This study examined clinical and psychological profiles across GOLD stages, with particular attention to GOLD stages 3 and 4. Methods: This multicenter observational study included 285 adults with spirometry-confirmed COPD evaluated in Romania between 2023 and 2026. COPD severity was classified according to GOLD stages. Clinical assessment included FEV1, peripheral oxygen saturation, smoking exposure, the COPD Assessment Test (CAT), and the modified Medical Research Council dyspnea scale (mMRC). Psychological and well-being measures included DASS depression, anxiety, and stress scores; WHO-5; major depressive disorder score, and generalized anxiety disorder score. Descriptive analyses were performed across GOLD stages, and GOLD 3 was directly compared with GOLD 4. Results: GOLD 3 was the largest subgroup (n = 106, 37.2%), followed by GOLD 4 (n = 81, 28.4%), GOLD 2 (n = 69, 24.2%), and GOLD 1 (n = 29, 10.2%). GOLD 3 patients showed marked dyspnea and symptom burden, with mean mMRC = 2.92 and CAT = 24.44. DASS depression, anxiety, and stress scores were higher in GOLD 3 than GOLD 2, but did not increase further in GOLD 4. Direct GOLD 3 versus GOLD 4 comparisons showed no significant differences in DASS depression or DASS anxiety, whereas GOLD 4 had a significantly higher mMRC, major depressive disorder score, and generalized anxiety disorder score. Conclusions: GOLD 3 COPD was associated with substantial dyspnea, functional limitation, and measurable psychological distress. However, depression and anxiety patterns varied by instrument, suggesting that psychological burden in COPD is multidimensional and not explained by spirometric severity alone.

The World Health Organization (WHO) declares COVID 19 pandemic in March 2020. Each pandemic wave had different clinical and biological characteristics, the expression of the disease being correlated with the dominant viral variant. Patients with COVID 19 have a pro-coagulant status, which predisposes them to thromboembolic complications. The current study aims to systematize the symptoms of COVID 19 and to highlight its relationship with the suspicion and confirmation of the diagnosis of pulmonary thromboembolism. We performed a descriptive retrospective study on patients with COVID 19 for a period of 4 months (September-December 2021). During this period, 183 were hospitalized with COVID 19 and 53 were enrolled in the study. Incidence of COVID 19 was 63% (33) in men and 37% for women. The average age of women was 68 years compared to men where the average age was 61 years. We observed a higher incidence of the disease in men in the 41–60 age group (39% of all men), while, in women, the most affected age group was 61–80 years (60% of all women). Pulmonary thromboembolism (PE) was diagnosed by pulmonary artery angiography, with an incidence of 57% in the study group affecting 60% of women and 55% of men. The symptoms are dominated by fever, cough and dyspnea. Fever was present in 65% of women and 55% of men, cough was present in 65% of women and 79% of men, while dyspnea involved 40% of women and 42% of men. In conclusion, PE was a common complication in COVID patients that contributed to adverse outcome and higher mortality. The symptoms were not specific to minor forms of the disease.

Background: Chronic obstructive pulmonary disease (COPD) is frequently complicated by psychological distress and suboptimal treatment adherence, both of which adversely affect clinical outcomes. However, the relationship between disease severity, emotional well-being, and adherence behavior remains insufficiently characterized. Methods: This multicenter observational study included 285 patients with COPD recruited from two primary care clinics. COPD severity was classified according to GOLD criteria. Psychological well-being was assessed using the World Health Organization–Five Well-Being Index (WHO-5), and treatment adherence was evaluated using the Medication Adherence Report Scale (MARS). Multidimensional relationships between clinical variables, WHO-5, and MARS were explored using correspondence analysis with symmetrical normalization. Results: Most patients had severe or very severe COPD (GOLD 3–4, 65.6%). WHO-5 scores showed marked heterogeneity across all GOLD stages, with very low values (20–26%) contributing disproportionately to the overall data structure (total contributions up to 0.97), indicating substantial anxiety and depression-related burden. Non-adherent patients represented 28.4% of the cohort but accounted for 71.6% of the inertia in the adherence-related correspondence analysis, forming a distinct psychological and behavioral profile. Mean GOLD stage was comparable between adherent and non-adherent patients (approximately 2.8–3.0). Conclusions: Correspondence analysis demonstrated substantial heterogeneity in WHO-5 and MARS profiles across all GOLD stages. Notably, mean GOLD severity was comparable between adherent and non-adherent patients (approximately 2.8–3.0), indicating that differences in adherence behavior were not primarily driven by spirometric disease severity.