[Rare case of multiple pulmonary nodules--a case report]. / Cauza rara de noduli pulmonari multipli--caz clinic.

The article presents the case of a 44 years old female patient admitted in the hospital for a solitary pulmonary nodule discovered through a chest X-ray performed for left thoracic pain. Despite the young age, a lot of comorbidities were present: severe dyslipidemia, ischemic right cerebellar lesion, degenerative periventricular lesions, chronic autoimmune thyroiditis, uterine fibroma, fibrocystic mastitis, polyglobulia of uncertain etiology and Rendu-Osler disease. The investigation which showed the nature of the pulmonary nodule was the CT scan with intravenous contrast, which demonstrated that the nodules were in fact arterial-venous malformations as part of the Rendu-Osler disease. This case offers the opportunity to discuss about etiopathogeny, morphopathology, criteria of diagnosis and treatment principles in Rendu-Osler disease.

[Non-Invasive Mechanical Ventilation in COPD exacerbations]. / Ventilatia mecanica non-invaziva în exacerbarile BPCO.

Non-Invasive Mechanical Ventilation (NIMV) is often considered as first indication of ventilatory support in COPD exacerbations. Controlled studies with NIMV performed in specialized centers report avoidance of endotracheal intubation in more than 70% of patients with COPD and ventilatory support, a reduction of time spent in ICU and a mortality of less than 10%. These good results are obtained with a proper selection of patients needing NIMV a well trained personnel, familiarized with the technique of NIMV and the availability of the necessary equipment. The most frequent techniques of NIMV are with facial or nasal masks. For hypoxemic patients oxygen-therapy with helmet can be a good option. The most popular modes of ventilation are those with pressure or volume support. The initial settings of the ventilator (pressure, tidal volume, respiratory rate, PEEP) are dependent on the patients' respiratory pattern, the type of ventilator and the skills of the respiratory therapist.

[The plurality of risk factors in a case of right-sided pneumonectomy]. / Cumul de factori de risc într-un caz de pneumonectomie dreapta.

A right lung cancer case is presented, aged 65 years, obese, submitted to a right lung resection. Stress is laid on the difficult evolution concerning the haemodynamics and particularly the breathing owing to the association of risk factors.