Advances in Respiratory Medicine

175 KiB

Open AccessConference Report

Report from BAL/WASOG International Conference 2008

by Joanna Domagała-Kulawik, Anna Dubaniewicz, Agnieszka Jarzemska, Anna Golian-Geremek and Elżbieta Puścińska

Adv. Respir. Med. 2009, 77(1), 111-114; https://doi.org/10.5603/ARM.27853 - 19 Dec 2009

Viewed by 274

Abstract

XI Międzynarodowa Konferencja BAL, ponownie zorganizowana w Grecji pod przewodnictwem prof. Stavrosa Constantopoulusa, została połączona z IX Spotkaniem World Association of Sarcoidosis and Other Granulomatous Diseases (WASOG) [...] Full article

223 KiB

Open AccessConference Report

Report from an Annual Congress of the European Respiratory Society, Berlin, 4–8 October 2008

by Michał Bednarek, Ryszarda Chazan, Joanna Chorostowska-Wynimko, Dorota Górecka, Maria Korzeniewska, Jan Kuś, Elżbieta Radzikowska and Jan Zieliński

Adv. Respir. Med. 2009, 77(1), 97-110; https://doi.org/10.5603/ARM.27852 - 19 Dec 2009

Viewed by 262

Abstract

Problematyka zaburzeń oddychania w czasie snu była reprezentowana na kongresie dość szeroko, obejmując: jedno sympozjum, trzy sesje doniesień ustnych, dwie sesje doniesień elektronicznych (e-communication), siedem sesji plakatowych, a ponadto dwie sesje „Gorący Temat” (Hot Topic) i praktyczny warsztat dotyczący [...] Read more.

Problematyka zaburzeń oddychania w czasie snu była reprezentowana na kongresie dość szeroko, obejmując: jedno sympozjum, trzy sesje doniesień ustnych, dwie sesje doniesień elektronicznych (e-communication), siedem sesji plakatowych, a ponadto dwie sesje „Gorący Temat” (Hot Topic) i praktyczny warsztat dotyczący stosowania nCPAP (nasal continuous positive airway pressure treatment). Najszerzej dyskutowano problematykę obturacyjnego bezdechu sennego (OBS) [...] Full article

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Open AccessCase Report

Common Variable Immunodeficiency in a Patient with Suspected Sarcoidosis

by Katarzyna Modrzewska, Elżbieta Wiatr, Renata Langfort, Karina Oniszh and Kazimierz Roszkowski-Śliż

Adv. Respir. Med. 2009, 77(1), 91-96; https://doi.org/10.5603/ARM.27843 - 19 Dec 2008

Viewed by 344

Abstract

Common variable immunodeficiency is a primary immunodeficiency disease, characterized by hypogammaglobulinemia, low serum immunoglobulin concentrations, and recurrent bacterial infections of the respiratory and gastrointestinal tracts. We report on a 33-year-old patient with suspected sarcoidosis, diagnosed on the basis of an open lung biopsy, [...] Read more.

Common variable immunodeficiency is a primary immunodeficiency disease, characterized by hypogammaglobulinemia, low serum immunoglobulin concentrations, and recurrent bacterial infections of the respiratory and gastrointestinal tracts. We report on a 33-year-old patient with suspected sarcoidosis, diagnosed on the basis of an open lung biopsy, who was admitted to the National Tuberculosis and Lung Diseases Research Institute because of severe pneumonia and streptococcal sepsis. During diagnostics based on typical, clinical and laboratory features, CVID was diagnosed. The antibiotic treatment was successfully administered and the patient was directed to supplementary treatment. Full article

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Open AccessEditorial

Novel Concepts in the Pharmacotherapy of Chronic Obstructive Pulmonary Disease

by Bartolome R. Celli

Adv. Respir. Med. 2009, 77(1), 82-90; https://doi.org/10.5603/ARM.27857 - 19 Dec 2008

Viewed by 258

Abstract

Chronic obstructive pulmonary disease (COPD) is highly prevalent and will continue to be an increasing cause of morbidity and mortality worldwide. COPD is now viewed under a new paradigm as preventable and treatable. In addition, it has become accepted that COPD is not [...] Read more.

Chronic obstructive pulmonary disease (COPD) is highly prevalent and will continue to be an increasing cause of morbidity and mortality worldwide. COPD is now viewed under a new paradigm as preventable and treatable. In addition, it has become accepted that COPD is not solely a pulmonary disease but also one with important measurable systemic consequences. It follows, that patients diagnosed with COPD have to be comprehensively evaluated to determine the extent of disease so that therapy can be adequately individualized. We now know that smoking cessation, oxygen for hypoxemic patients, lung reduction surgery for selected patients with emphysema, and non-invasive ventilation during severe exacerbations have an impact on mortality. The completion of well planned pharmacological trials have shown the importance of patient centered outcomes and the possible impact on mortality and rate of decline of lung function. This monograph presents an update on the pharmacological therapy of COPD. The future for patients with COPD is bright as primary and secondary prevention of smoking becomes more effective and air quality improves. In addition, current research will unravel the pathogenesis, clinical and phenotypic manifestations of COPD thus providing exciting therapeutic targets. Ultimately, the advent of newer and more effective therapies will lead to a decline in the contribution of this disease to poor world health. Full article

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Open AccessEditorial

Early Diagnosis of COPD—Rationale, Methods and Effects

by Jan Zieliński

Adv. Respir. Med. 2009, 77(1), 77-81; https://doi.org/10.5603/ARM.27856 - 19 Dec 2008

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Abstract

Wczesne rozpoznawanie choroby było i pozostaje wielkim wyzwaniem współczesnej medycyny [...] Full article

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Open AccessEditorial

Physical Activity in Patients with COPD: The Role of Pulmonary Rehabilitation

by Richard ZuWallack

Adv. Respir. Med. 2009, 77(1), 72-76; https://doi.org/10.5603/ARM.27855 - 19 Dec 2008

Viewed by 295

Abstract

Physical activity is defined by the World Health Organization as “any force exerted by the skeletal muscles that results in energy expenditure above resting level” [...] Full article

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Open AccessEditorial

Molecular Mechanisms of Inflammation in Chronic Obstructive Pulmonary Disease

by Aleksandra Semik-Orzech and Władysław Pierzchała

Adv. Respir. Med. 2009, 77(1), 66-71; https://doi.org/10.5603/ARM.27854 - 19 Dec 2008

Viewed by 292

Abstract

Przewlekła obturacyjna choroba płuc (POChP) stanowi obecnie jedną z najczęstszych przyczyn zachorowalności na świecie. Szacuje się, że choruje na nią niemal 210 milionów ludzi i że do 2020 roku stanie się ona trzecią w kolejności przyczyną zgonów [...] Full article

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Open AccessReview

Tuberculosis after Renal Transplantation

by Anna Korzeniewska, Tomasz Dyła, Monika Kosacka and Renata Jankowska

Adv. Respir. Med. 2009, 77(1), 61-65; https://doi.org/10.5603/ARM.27846 - 19 Dec 2008

Viewed by 279

Abstract

Renal transplant recipients carry a relatively high risk of developing tuberculosis (TB). In most cases, active TB is the result of reactivation of a latent infection and is located in the lungs. In these patients, clinical presentation of TB can often be atypical [...] Read more.

Renal transplant recipients carry a relatively high risk of developing tuberculosis (TB). In most cases, active TB is the result of reactivation of a latent infection and is located in the lungs. In these patients, clinical presentation of TB can often be atypical and there is a high risk of dissemination and high mortality rates. Therefore, the use of invasive procedures for proper diagnosis is recommended, as well as anti-tuberculosis therapy instituted whenever there is a strong suspicion of TB on clinical grounds, even without microbiological evidence. The treatment of active TB in renal transplant recipients should be the same as in the general population. To avoid graft rejection, blood levels of calcineurin inhibitors should be monitored closely. Prophylaxis is recommended for high-risk patients. Full article

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Open AccessReview

Angiogenesis in Interstitial Lung Diseases

by Tadeusz M. Zielonka

Adv. Respir. Med. 2009, 77(1), 52-60; https://doi.org/10.5603/ARM.27845 - 19 Dec 2008

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Abstract

Interstitial lung diseases (ILD) constitute a large group of disorders characterized by various etiology and pathogenesis. Inflammation and pulmonary fibrosis are the most important processes in the course of ILD. Disease causes the decrease of the gas diffusion in the lungs and provokes [...] Read more.

Interstitial lung diseases (ILD) constitute a large group of disorders characterized by various etiology and pathogenesis. Inflammation and pulmonary fibrosis are the most important processes in the course of ILD. Disease causes the decrease of the gas diffusion in the lungs and provokes hypoxia. Chronic inflammation and hypoxia are strong stimulus of neovascularization. Neoangiogenesis is a principal response of vessels to inflammation. The critical importance of tumor angiogenesis in the development and metastatic spread of tumors is proved. Relations of ILD with neoplasma have been observed. Neovascularization takes an important role in wound healing allowing the cells to flow into damaged structures. Recently, pulmonary fibrosis has been deemed to result from abnormal wound healing in the lung in response to injury to the alveolar epithelium. Angiogenesis participates in pathogenesis of idiopathic pulmonary fibrosis. More and more data suggest the role of angiogenesis in pathogenesis of other ILDs, such as granulomatosis, fibrosis and vasculitis. The mechanism of angiogenesis in ILD is not clear yet. New data concerning participation of neoangiogenesis in pathogenesis of ILD created target for new drugs. Thalidomide, a strong antiangiogenic drug was used successfully in the some cases of ILD. Full article

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Open AccessReview

Omalizumab, Recombinant Humanized Monoclonal Antibody Anti-IgE—New Fields of Studies on the Therapeutic Indications

by Izabela Kupryś-Lipińska and Piotr Kuna

Adv. Respir. Med. 2009, 77(1), 43-51; https://doi.org/10.5603/ARM.27844 - 19 Dec 2008

Cited by 1 | Viewed by 242

Abstract

Omalizumab is the monoclonal antibody against IgE, which blocks the binding of IgE to receptors on effector cells and this way blocks or decreases allergic reaction and asthma symptoms. Nowadays omalizumab is registered in the USA and European Union including Poland for treatment [...] Read more.

Omalizumab is the monoclonal antibody against IgE, which blocks the binding of IgE to receptors on effector cells and this way blocks or decreases allergic reaction and asthma symptoms. Nowadays omalizumab is registered in the USA and European Union including Poland for treatment of patients with severe persistent, uncontrolled asthma. It is very effective in the reduction of asthma exacerbations, hospitalizations and emergency visits, it decreases intensity of symptoms and improves the quality of life. But omalizumab has more extensive action; given subcutaneously it has systemic effect. The article is the review of the studies and case reports on usage of omalizumab in new indications. Some authors’ own experiences in this field are also presented. Full article

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Open AccessArticle

Analysis of Solitary Pulmonary Nodules Found in Chest Radiograms

by Marta Dąbrowska, Anna Kolasa, Małgorzata Żukowska, Jan Lesiński, Joanna Domagała-Kulawik, Marta Maskey-Warzęchowska, Rafał Krenke, Olgierd Rowiński and Ryszarda Chazan

Adv. Respir. Med. 2009, 77(1), 37-41; https://doi.org/10.5603/ARM.27851 - 19 Dec 2008

Cited by 1 | Viewed by 290

Abstract

Introduction: The detection of solitary pulmonary nodules (SPNs) has increased due to widespread use of computed tomography; nevertheless, chest radiographs still remain the basic routine examination. The aim of the study was to estimate the detection of SPNs in routine chest X-rays [...] Read more.

Introduction: The detection of solitary pulmonary nodules (SPNs) has increased due to widespread use of computed tomography; nevertheless, chest radiographs still remain the basic routine examination. The aim of the study was to estimate the detection of SPNs in routine chest X-rays in hospitalized patients and to assess the incidence of malignancy in newly diagnosed SPNs. Material and methods: We analyzed 5726 routine chest radiographs of patients admitted to the Department of Internal Diseases, Pneumology and Allergology in 2004 and 2005. Most of the patients were admitted to hospital due to emergency reasons. The malignant nature of the nodules was confirmed by pathological examination. The nature of benign nodules was confirmed either by pathological examination or based on radiological criteria: no growth within 2 years of radiological follow up, regression in control radiograms or CT scans, benign pattern of calcification. Results: Among the 5726 radiograms we found 116 newly diagnosed SPNs (2.2%). Twenty-four nodules (21%) were malignant: NSCLC in 21 cases and metastases in 3 cases. Fifty-one nodules (44%) were benign. In 19 patients (16%) SPNs proved to be artefacts or erroneously interpreted extrathoracic lesions. In 22 cases (19%) there was no final diagnosis (lack of data, diagnostic procedure renunciation). Conclusion: The incidence of newly detected SPNs in chest X-rays was 2.2%. Most SPNs were benign. About 21% of SPNs were diagnosed as malignant. Full article

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Open AccessArticle

Styles of Coping with Stress and Emotional Functioning in Patients with Asthma

by Katarzyna Lewandowska, Krzysztof Specjalski, Ewa Jassem and Jan Marek Słomiński

Adv. Respir. Med. 2009, 77(1), 31-35; https://doi.org/10.5603/ARM.27850 - 19 Dec 2008

Cited by 1 | Viewed by 245

Abstract

Introduction: The evaluation of styles of coping with stress resulting from a somatic disease was always considered controversial, since the stress is a consequence of the complexity of the disease as a stressful event and is linked with every field of human [...] Read more.

Introduction: The evaluation of styles of coping with stress resulting from a somatic disease was always considered controversial, since the stress is a consequence of the complexity of the disease as a stressful event and is linked with every field of human life and activity. The main aim of this study was to evaluate the effectiveness of various styles of coping with stress—task-oriented, emotion-oriented, or avoidance-oriented—used by patients with asthma to cope with their disease and its consequences. Material and methods: 100 patients with asthma were examined including 15 with mild asthma, 40 with moderate asthma, and 45 with severe asthma. The first group consisted of patients with mild-to-moderate asthma and the second group of patients with severe asthma. The subjects were mainly females (69% women, 31% men) aged from 19 to 75 years, with at least primary level of education. The following questionnaires were used: Coping Inventory for Stressful Situations (CISS), UWIST Mood Adjective Check List (UMACL), and Asthma Control Test (ACT). Results: Task-oriented style had a positive influence on emotions (p < 0.05) in patients with moderate asthma. Avoidance-oriented style had a positive influence on emotions (p < 0.05) in patients with severe asthma. Emotion-oriented style proved ineffective and had a negative influence on emotions (p < 0.05) in all patients. Conclusions: Coping style plays a key role in the emotional functioning of asthmatics. Moreover, incorporation of an individual style of coping with stress in the therapeutic process is necessary. Full article

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Open AccessArticle

Abnormalities in High-Resolution Computed Tomography of the Lungs in Patients with Idiopathic Pulmonary Arterial Hypertension—Correlation with Haemodynamic Parameters and Prognostic Significance

by Aneta Kacprzak, Monika Szturmowicz, Barbara Burakowska, Anna Fijałkowska, Marcin Kurzyna, Maria Wieteska, Michał Florczyk, Joanna Żyłkowska, Monika Franczuk, Stefan Wesołowski and Adam Torbicki

Adv. Respir. Med. 2009, 77(1), 23-30; https://doi.org/10.5603/ARM.27849 - 19 Dec 2008

Cited by 1 | Viewed by 295

Abstract

Introduction: The risk stratification in idiopathic pulmonary arterial hypertension (IPAH) patients is currently based on haemodynamic and functional parameters as well as serum biomarker concentrations. Until now the importance of changes appearing in high-resolution computed tomography (HRCT) of the lungs of patients [...] Read more.

Introduction: The risk stratification in idiopathic pulmonary arterial hypertension (IPAH) patients is currently based on haemodynamic and functional parameters as well as serum biomarker concentrations. Until now the importance of changes appearing in high-resolution computed tomography (HRCT) of the lungs of patients with IPAH has not been investigated. Material and methods: Lung HRCT scans were analysed retrospectively in 48 IPAH patients (patients): 37 women, 11 men, mean age 41 ± 15 years. Results: Focal ground-glass opacifications (FGG) were found in 12 patients (25%), and centrilobular nodules (CN) were found in 8 patients (17%). In the remaining 58% of patients HRCT revealed no changes (N). Significantly lower stroke volume was found in the CN group (41.0 ± 8.5 ml) compared to 60.8 ± 15.1 ml in the FGG group and 58.1 ± 18.0 ml in the N group (p = 0.03). Right atrial pressure was significantly higher in the CN group (12.2 ± 4.86 mm Hg) than in the FGG group (6.9 ± 3.9 mm Hg) and the N group (7.6 ± 5.3 mm Hg), p = 0.047. The presence of nodules was combined with considerably increased risk of death, both in univariate analysis (HR 5.35, 95% CI: 1.16–24.7, p = 0.03) and in multivariate analysis (HR 6.98, 95% CI: 1.41–34.59, p = 0.02). Ground-glass opacifications correlated neither with haemodynamic nor functional indexes, and were of no prognostic significance. Conclusions: The presence of centrilobular nodules in lung HRCT scans of IPAH patients was combined with more severe haemodynamic compromise and was an independent negative prognostic indicator. Full article

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Open AccessArticle

Treatment Outcomes in Culture-Positive Pulmonary Tuberculosis

by Izabela Siemion-Szcześniak and Jan Kuś

Adv. Respir. Med. 2009, 77(1), 11-22; https://doi.org/10.5603/ARM.27848 - 19 Dec 2008

Cited by 1 | Viewed by 304

Abstract

Introduction: The aim of the study was to evaluate treatment outcomes in sputum culture positive patients with tuberculosis in three Polish provinces (Warsaw, Gdansk and Siedlce Provinces) in 1995 and again in 2000. We also assessed whether the implementation of the Directly [...] Read more.

Introduction: The aim of the study was to evaluate treatment outcomes in sputum culture positive patients with tuberculosis in three Polish provinces (Warsaw, Gdansk and Siedlce Provinces) in 1995 and again in 2000. We also assessed whether the implementation of the Directly Observed Therapy Short Course (DOTS) strategy in the former Gdansk Province led to improved outcomes compared to the outcomes observed in 1995, when this strategy was not being followed. Material and methods: We started the study by reviewing microbiology registers covering the years 1995 and 2000 from all the tuberculosis laboratories in three provinces (Warsaw, Gdansk and Siedlce Provinces) and identified sputum culture positive patients. We then reviewed inpatient and outpatient medical records of patients who had been with pulmonary tuberculosis diagnosed and confirmed by bacteriology in 1995 and 2000. Treatment outcomes were evaluated in accordance with the World Health Organisation (WHO) recommendations and classified as: cure, treatment completed, default, treatment failure, death or other. Results: A total of 708 patients were included in the study: 373 diagnosed in 1995 and 335 diagnosed in 2000. According to the WHO criteria, the treatment success rate (the sum of cures and treatment completions) in 1995 and 2000 was 58.8% and 54.0%, the default rate was 15.5% and 17.9%, the failure rate was 2.4% and 2.7% and the death rate was 5.6% and 6.3%, respectively. The rate of outcomes classified as “other” was 18.2% and 22.1%, respectively. Following the implementation of the DOTS strategy in Gdansk Province, treatment outcomes in significantly improved in 2000 compared to the year 1995. The treatment success rate was 89.6% vs. 69.3% (p = 0.0037), the default rate was 0.0% vs. 14.7% (p = 0.0005) and the death rate was 0.0% vs. 9.3% (p = 0.0184). Conclusions: The treatment success rate (the rate of cures and treatment completers) in 1995 and 2000 was 58.8% and 54.0% and was lower than that recommended by WHO (at least 85%). The results demonstrated that the treatment outcomes in the former Gdansk Province in 2000, following the implementation of the DOTS strategy, were significantly better than those in 1995, when the strategy was not being followed. Treatment success was observed in 89.6% and 69.3% of the patients, respectively (p = 0.0037). Full article

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Open AccessArticle

Association of A/T Polymorphism of the CHRM2 Gene with Bronchodilator Response to Ipratropium Bromide in Asthmatic Children

by Aleksandra Szczepankiewicz, Anna Bręborowicz, Paulina Sobkowiak, Lucyna Kramer and Anna Popiel

Adv. Respir. Med. 2009, 77(1), 5-10; https://doi.org/10.5603/ARM.27847 - 19 Dec 2008

Cited by 3 | Viewed by 324

Abstract

Introduction: The aim of this study was to analyze the possible association of A/T polymorphism of the CHRM2 gene with asthma, and pharmacogenetic analysis of the polymorphism with bronchodilator response to ipratropium bromide, an anticholinergic drug used in asthma. Material and methods [...] Read more.

Introduction: The aim of this study was to analyze the possible association of A/T polymorphism of the CHRM2 gene with asthma, and pharmacogenetic analysis of the polymorphism with bronchodilator response to ipratropium bromide, an anticholinergic drug used in asthma. Material and methods: Analysis was performed in a group of 113 children diagnosed with bronchial asthma, and in a group of 123 healthy children from a control group. Moreover, in the group of 32 asthmatic children without concurrent treatment with long-acting β₂-agonists, bronchodilator response to ipratropium bromide was evaluated by the spirometric lung function test. Genetic analysis was performed for A/T polymorphism (rs6962027) of the CHRM2 gene. Genotyping was done with the PCR-RFLP method. Statistical analysis was performed using Statistica v.7.1 software. Results: No association of A/T polymorphism was found with asthma (p = 0.865 for genotypes and p = 0.782 for alleles). In the pharmacogenetic analysis, it was observed that patients carrying TT genotype of CHRM2 gene polymorphism demonstrated significantly poorer response to anticholinergic drug as compared to the patients with other genotypes for this polymorphism (p = 0.035). Conclusions: We found that TT genotype in the CHRM2 gene was associated with poor bronchodilator response in asthmatic patients. The results should be analyzed carefully considering the small sample size and should be confirmed by other research groups. Full article

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Open AccessEditorial

Reducing the Burden of Chronic Respiratory Diseases

by Pneumonologia i Alergologia Polska Editorial Office

Adv. Respir. Med. 2009, 77(1), 3-4; https://doi.org/10.5603/ARM.27842 - 19 Dec 2008

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Abstract

Reducing the burden of chronic respiratory diseases [...] Full article

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Adv. Respir. Med., Volume 77, Issue 1 (January 2009) – 16 articles , Pages 3-114

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