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RSP – a reliable and overactive society

Florin Dumitru Mihălțan

November was a full month, with many events where the Romanian Society of Pneumology (RSP) was either the organizer, or the partner, covering four projects that recon-firm once again that it is a responsible and professional association.

The date of November 12 marked the press conference as a preamble of the World Day Against Chronic Obstructive Pulmonary Disease (COPD) and the free spirometry testing conducted in front of the Unirea Shopping Center, on November 17-18, 2018. In Romania, approximately one million people suffer from COPD. This disease, which is often diagnosed too late, precisely because its symptoms are not specific and can easily be confounded with either the effects of smoking or those of aging, was analyzed and presented to the public with its specific symptoms: cough, expectoration, choking, fatigue, low effort tolerance. At the same time, the preliminary data of the second national COPD survey were presented for the first time in the coun-try. The campaign “Do you know how old your lungs are?” thus reached the 10th edition. With the occasion of this campaign, 703 people were tested and the RSP offer was appreciated by the population.

The National Day without Tobacco – a day proposed by the Romanian Government, provided by the art. 107 par. (2) of the Constitution and the art. 8 of the Law no. 349/2002 on the prevention and combating the effects of tobacco products consumption and adopted by Decision 1270/2002 in order to raise the awareness of the population of Romania regarding the benefit of quitting smoking – was another event in November. It was celebrated differently from previous years in a press conference held at the headquarters of the National College of Physicians. The subject, which was not accidentally approached on this occasion, at this location for 2018 was: “The medical community is gathering the ranks in the fight against the promotion of tobacco consumption”. In the evolution context of 2018 regarding strategical shift in the marketing of transna-tional tobacco companies in recent years through new prod-ucts (electronic cigarettes, heated tobacco products) and positioning, the Romanian and international medical com-munity was found facing off a seemingly “new” challenge, but similar to the one thirty-forty years ago, when less harmful conventional tobacco offers were widely promoted for the “benefit” of the consumer. On one hand, there was a trend in 2018 of smoking “renormalization” in the new alternative offered by the transnational tobacco companies and, on the other hand, there were attempts to infiltrate the tobacco industry in the medical activities of non-gov-ernmental organizations and professional medical associa-tions, with attempts of associating the name of recruited doctors under contract by the industry with the names of medical personalities and academics recognized for the effort made for years in the field of tobacco control. At the initiative of RSP representatives, the nucleus that consisted of Romanian Society of Pneumology, Romanian Society of Cardiology (SRC), Romanian National Society of Family Medicine (SNMF), Romanian Society of Internal Medicine (SRMI) and Heart Foundation, who were joined by the Romanian Academy (through the Medical Science Section), the Academy of Medical Sciences – Internal Medicine Department, Prevention Forum (FP), The European Network for Smoking Prevention (ENSP) and the “First Tobacco-Free Generation Initiative” generated at this press conference at the headquarters of the National College of Physicians, starting from the principles of the “Framework Convention on Tobacco Control”, transposed into Law no. 332/2005, related to the prevention of interference of the commercial interests of the tobacco industry in public health decision-making processes, professional medical and patient associations, the delimitation of these activities of the tobacco industry by healthcare professionals who no longer have to accept funding from it and not to be manipu-lated about the so-called less harmful effects of new offers of electronic cigarettes and tobacco products.

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In order to make the relationship with the tobacco industry more transparent for any “white coat” and a new code of ethics, dr. Magda Ciobanu (WHO expert) exposed a model of a statement (interests or conflicts of interest) to allow the knowledge of possible contractual or sponsorship relation-ships from the tobacco industry with doctors, professional associations and NGOs with a medical or pharmaceutical background public health. This model, which will be final-ized after this conference, will be proposed to all the doc-tors and professionals or patient associations in the country, and will be discussed to get a final form at the Romanian College of Physicians Forum and in the boards of professional associations. The conclusions of this press conference were that the only way to reduce the risk of smoking-induced illness is to give up completely any form of tobacco consumption, as the World Health Organization has been drawing attention since 2006, saying that “tobacco is lethal in any form and anyway disguised”.

Another event where the SRP has made a partnership with the “Marius Nasta” Pneumophtisiology Institute was recorded on November 20, 2018. The two institutions offi-cially launched on November 20, 2018, the E-DETECT TB program, the first active tuberculosis detection campaign in our country, carried out through a mobile caravan.

E-DETECT TB is in fact part of a wider project at European level in countries like Bulgaria, Italy, Great Britain, the Netherlands, Romania and Sweden, and includes several components, among which there are active diagnostics (for Romania and Bulgaria) being imple-mented within the National Program for Prevention, Supervision and Control of Tuberculosis in Romania (PNPSCT), coordinated by the “Marius Nasta” Pneumophtisiology Institute in order to ensure the early detection, active, of patients with tuberculosis (TB). This part of the project was welcomed, given that tuberculosis is a major public health problem in Romania, with the highest disease incidence among all EU countries. The vulnerable people will be at the heart of the E-DETECT TB project, and the active detection with these caravans will include: inmates, homeless people, Romani people, drug users, and very poor populations, with limited access to health-care. The project size will allow for the examination of about 20,000 people in the E-DETECT TB, with the possibility of extending up to 25,000 beneficiaries. The examinations will be carried out with the help of mobile medical units equipped with imaging equipment and molecular diagnostics by specialists from the “Marius Nasta” Pneumophtisiology Institute and the support of PNPSCT. The first step is to complete a medical question-naire at the entrance of the person who will be examined in the mobile medical unit and then the recording of the medical and sociodemographic data. After that, a lung radiograph will be performed, which will be transmitted via a telemedicine system to the “Marius Nasta” Institute of Pneumophysiology, where a pneumologist within the project will analyze the image result. At the same time, another interpretation is going to be made from a physi-cian from the Dutch partner, KNCV Tuberculosis Foundation.

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The identified TB suspects after anamnesis, in which the result of the radiograph was abnormal, will give a sputum sample for the bacteriological investigation. For the sputum exam, the mobile medical unit is equipped with an advanced automated diagnostic system that can identify the DNA of the Mycobacterium tuberculosis com-plex (MTB) and the resistance to one of the antibiotics used in the TB treatment. The patients diagnosed with TB will subsequently enter a complete treatment and mon-itoring program (including treatment-enhancing inter-ventions) according to the national recommendations on TB control. The total value of the project in our country was 970,449 euros and it was co-financed by the Ministry of Health, which allocated 612,069 euros.

The date of November 21, 2018 marked another press conference, because November was and has traditionally remained the Lung Cancer Awareness Month throughout the world. In order to draw attention to the importance of early diagnosis of lung cancer, the Federation of Cancer Patients Associations (FABC) launched the campaign “Inspiring Hope”, with RSP as a partner. In 2018, in Romania, 83,461 new cases of cancer have been registered, and 50,902 Romanians are losing their lives due to cancer, according to GLOBOCAN’s recent statistics (Global Cancer Observatory, the world’s most up-to-date cancer world map) that recently published new data for Romanians.

The statistics show that 30% of cancer deaths in Romania are caused by lung cancer. The oncologists, pneumologists, patient associations representatives, etc. were present at this meeting and talked about the need for an early diagnosis, new treatment technologies, inno-vation, biological treatments, phenotypes, and new offi-cial therapeutic tests for lung cancer. The survivor testimonials of patients with a history of lung cancer came to reinforce the mass-media messages about the early identification and screening of any form of lung cancer.

All these events reconfirm the implication of RSP and the way in which Romanian pneumologists are committed to voluntary activities and collaboration with the authori-ties, the patient and the professional associations in the implementation of initiatives for the active prevention and detection of certain respiratory diseases.

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