Advances in Respiratory Medicine

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Open AccessLetter

Komentarz do artykułu W. Owczarka i wsp. "Gruźlica węzłów chłonnych szyi z ogniskiem gruźlicy rozpływnej—Opis przypadku"

by Ewa Rowińska-Zakrzewska

Adv. Respir. Med. 2009, 77(4), 430; https://doi.org/10.5603/ARM.27797 - 26 Jun 2009

Viewed by 218

Abstract

Praca Owczarka, Targowskiego, Łebkowskiej i Paluchowskiej pt. “Gruźlica węzłów chłonnych szyi z ogniskiem gruźlicy rozpływnej—opis przypadku” jest bardzo cenna [...] Full article

94 KiB

Open AccessBook Review

Recenzja książki prof. dr hab. Lidii Bernadety Brydak "Grypa. Pandemia grypy—Mit czy realne zagrożenie?"

by Wiesław Deptuła

Adv. Respir. Med. 2009, 77(4), 429; https://doi.org/10.5603/ARM.27798 - 26 Jun 2009

Viewed by 239

Abstract

To trzecie już wydanie monografii na temat grypy autorstwa profesor Lidii Bernadety Brydak [...] Full article

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Open AccessCase Report

Peritoneal Tuberculosis Mimicking Ovarian Cancer—Diagnostic Difficulties. A Report of Two Cases

by Jacek Zamłyński, Anita Olejek, Ewa Oleś, Katarzyna Stęplewska, Andrzej Krzywiecki, Grażyna Myrcik, Piotr Bodzek, Marta Paliga-Żytniewska and Alicja Gajewska

Adv. Respir. Med. 2009, 77(4), 422-427; https://doi.org/10.5603/ARM.27792 - 26 Jun 2009

Cited by 1 | Viewed by 233

Abstract

Tuberculosis, and particularly its extrapulmonary location, still causes diagnostic difficulties. In 2007, 7.3% of newly registered cases of tuberculosis in Poland were located extrapulmonarily. Peritoneal tuberculosis is often misdiagnosed as ovarian cancer due to similar symptoms such as: abdominal pain, abdominopelvic masses, ascites [...] Read more.

Tuberculosis, and particularly its extrapulmonary location, still causes diagnostic difficulties. In 2007, 7.3% of newly registered cases of tuberculosis in Poland were located extrapulmonarily. Peritoneal tuberculosis is often misdiagnosed as ovarian cancer due to similar symptoms such as: abdominal pain, abdominopelvic masses, ascites and elevated CA-125 serum concentration. We present reports of two patients with suspected ovarian cancer at admission. The patients’ complaints, as well as elevated serum levels of CA-125, suggested ovarian cancer. Chest X-rays showed a normal picture in one case and minimal fibrotic changes in the other. The results of additional tests were uncharacteristic. Based on the data obtained by diagnostic laparoscopy, observed clinical symptoms and the intraoperative picture, which all suggested ovarian cancer, a resection (total abdominal hysterectomy and bilateral salpingo-oophorectomy) was performed in both cases. Histological evaluation of biopsy specimens revealed peritoneal tuberculosis in both cases. Full article

427 KiB

Open AccessCase Report

Tubercular Inflammation of Cervical Lymph Nodes with a Colliquative Tuberculosis Focus—A Case Study

by Witold Owczarek, Tomasz Targowski, Katarzyna Łebkowska and Elwira Paluchowska

Adv. Respir. Med. 2009, 77(4), 417-421; https://doi.org/10.5603/ARM.27791 - 26 Jun 2009

Viewed by 291

Abstract

Cutaneous tuberculosis is a specific form of tuberculosis, characteristic of a differentiated clinical picture and resulting from either endo- or exogenous way of infection, immunological mechanisms and unfavourable conditions for mycobacterium development. The untypical course and symptoms of the disease may cause certain [...] Read more.

Cutaneous tuberculosis is a specific form of tuberculosis, characteristic of a differentiated clinical picture and resulting from either endo- or exogenous way of infection, immunological mechanisms and unfavourable conditions for mycobacterium development. The untypical course and symptoms of the disease may cause certain difficulties in obtaining a proper diagnosis and, in consequence, result in delayed onset of appropriate treatment. When diagnosing cutaneous tuberculosis, a broad apparatus of differential diagnostics should be applied, taking into account other diseases such as leishmaniasis, actinomycosis, leprosy or deep mycoses. We report a case of lymph node tuberculosis and of colliquative tuberculosis of the skin, at first erroneously diagnosed as actinomycosis, complicated by multiform erythema. In the reported case, no tuberculous bacilli were identified in bacteriological evaluations of bioptates collected from the skin changes. The final diagnosis of the disease was determined by the presence of specific granulation tissue in the last performed histopathological studies, as well as by hypersensitivity to tuberculin and the presence of mycobacterial DNA in PCR evaluation. According to the authors, in case of clinically suspected cutaneous tuberculosis, repeated (several) histopathological studies of samples from observed changes seem to be fairly justified. The results of histopathological studies should be completed by one of the methods of oligomycobacterial material evaluation, e.g., by identification of mycobacterial genetic material by means of nucleic acid amplification in the PCR method. Full article

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Open AccessReview

Ciężka i terminalna postać przewlekłej obturacyjnej choroby płuc

by Ewa Jassem and Dorota Górecka

Adv. Respir. Med. 2009, 77(4), 411-416; https://doi.org/10.5603/ARM.27799 - 26 Jun 2009

Viewed by 271

Abstract

Przewlekłą obturacyjną chorobę płuc (POChP) definiuje się jako schorzenie przebiegające z postępującym [...] Full article

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Open AccessReview

Familial Predisposition to Chronic Obstructive Pulmonary Disease

by Pneumonologia i Alergologia Polska Editorial Office

Adv. Respir. Med. 2009, 77(4), 407-410; https://doi.org/10.5603/ARM.27796 - 26 Jun 2009

Viewed by 292

Abstract

The role of cigarette smoking in development of chronic obstructive pulmonary disease (COPD) is well known, however only in about 20% of smokers clinical disease was diagnosed. It points to additional factors which influence the sensitivity to tobacco products. Familial clustering of COPD [...] Read more.

The role of cigarette smoking in development of chronic obstructive pulmonary disease (COPD) is well known, however only in about 20% of smokers clinical disease was diagnosed. It points to additional factors which influence the sensitivity to tobacco products. Familial clustering of COPD has been observed and genetic deficiency of alfa 1 antitrypsine with ZZ phenotype was proved to be a factor responsible for the early onset of this disease. However only 3% of COPD patients have this deficiency. The role of MZ phenotype of alfa 1 antitrypsine in the development of COPD and in the rate of decline of lung function were discussed. Association studies concerning the polymorphisms of “candidate genes” connected with pathophysiology of COPD were presented. Although some of those studies have shown the role of polymorphism of those genes in COPD, the results are not always reproducible. This may be due to small available population samples with poorly defined COPD phenotype. It is concluded that COPD is a complex disease influenced by multiple genes and environmental factors. Full article

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Open AccessReview

Najczęstsze zakażenia przeszczepionych płuc

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

Adv. Respir. Med. 2009, 77(4), 400-406; https://doi.org/10.5603/ARM.27795 - 26 Jun 2009

Viewed by 250

Abstract

Jednym z najczęstszych powikłań po przeszczepieniu płuc jest ich zakażenie. Wśród patogenów wywołujących infekcje znajdują się drobnoustroje oportunistyczne oraz pochodzące ze środowiska szpitalnego, przy czym najczęściej izolowane są Pseudomonas aeruginosa, cytomegalowirus oraz Aspergillus fumigatus. Ciężkość zakażeń oraz czas ich ujawnienia zależą [...] Read more.

Jednym z najczęstszych powikłań po przeszczepieniu płuc jest ich zakażenie. Wśród patogenów wywołujących infekcje znajdują się drobnoustroje oportunistyczne oraz pochodzące ze środowiska szpitalnego, przy czym najczęściej izolowane są Pseudomonas aeruginosa, cytomegalowirus oraz Aspergillus fumigatus. Ciężkość zakażeń oraz czas ich ujawnienia zależą w dużym stopniu od zastosowanej profilaktyki. Niektóre infekcje, specyficzne dla mukowiscydozy, mogą zasadniczo wpłynąć na około- i pooperacyjną śmiertelność. Poszczególne ośrodki różnią się w opinii, które zakażenia stanowią przeciwwskazanie do transplantacji. Full article

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Open AccessReview

Mikroangiopatia płucna w przebiegu cukrzycy

by Krzysztof Kuziemski, Lucyna Górska, Ewa Jassem and Aleksandra Madej-Dmochowska

Adv. Respir. Med. 2009, 77(4), 394-399; https://doi.org/10.5603/ARM.27794 - 26 Jun 2009

Cited by 1 | Viewed by 348

Abstract

Cukrzyca jest schorzeniem metabolicznym, charakteryzującym się przewlekłą hiperglikemią oraz nieprawidłową przemianą węglowodanów, białek i tłuszczów. To zaburzenie metabolizmu wynika z upośledzonego wydzielania insuliny, niewłaściwego oddziaływania insuliny na tkanki lub współistnienia obu mechanizmów jednocześnie. Długotrwała cukrzyca prowadzi do rozwoju mikroi/ lub makroangiopatii, co może [...] Read more.

Cukrzyca jest schorzeniem metabolicznym, charakteryzującym się przewlekłą hiperglikemią oraz nieprawidłową przemianą węglowodanów, białek i tłuszczów. To zaburzenie metabolizmu wynika z upośledzonego wydzielania insuliny, niewłaściwego oddziaływania insuliny na tkanki lub współistnienia obu mechanizmów jednocześnie. Długotrwała cukrzyca prowadzi do rozwoju mikroi/ lub makroangiopatii, co może wywierać niekorzystny wpływ na czynność wielu narządów. Mikroangiopatia dotyczy szczególnie narządu wzroku (retinopatia), nerek (nefropatia) i obwodowego układu nerwowego (neuropatia). Mało poznany pozostaje wpływ mikroangiopatii cukrzycowej na czynność płuc. Nieliczne dostępne badania donoszą o ograniczeniu rezerw wentylacyjnych układu oddechowego i upośledzeniu pojemności dyfuzyjnej płuc dla tlenku węgla u chorych na cukrzycę zarówno typu 1, jak i 2. Może to świadczyć o uszkodzeniu bariery pęcherzykowo-włośniczkowej w płucach w przebiegu cukrzycy. W pracy przedstawiono przegląd dostępnego piśmiennictwa dotyczącego mikroangiopatii płucnej i jej wpływu na stan czynnościowy układu oddechowego. Full article

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Open AccessReview

Niegenomowy mechanizm działania glikokortykosteroidów

by Alicja Grzanka and Jerzy Jarząb

Adv. Respir. Med. 2009, 77(4), 387-393; https://doi.org/10.5603/ARM.27793 - 26 Jun 2009

Cited by 4 | Viewed by 671

Abstract

W pracy przedstawiono aktualną wiedzę dotyczącą mechanizmów działania glikokortykosteroidów (GK). Zgodnie z klasycznym modelem działania, określanym jako genomowy, GK wpływają (bezpośrednio lub pośrednio) na transkrypcję i translację genów kodujących mediatory procesu zapalnego. Aktualne badania podkreślają jednak znaczenie nietranskrypcyjnych oddziaływań GK, które ujawniają się [...] Read more.

W pracy przedstawiono aktualną wiedzę dotyczącą mechanizmów działania glikokortykosteroidów (GK). Zgodnie z klasycznym modelem działania, określanym jako genomowy, GK wpływają (bezpośrednio lub pośrednio) na transkrypcję i translację genów kodujących mediatory procesu zapalnego. Aktualne badania podkreślają jednak znaczenie nietranskrypcyjnych oddziaływań GK, które ujawniają się szybko—od kilkunastu sekund do kilkunastu minut. W niegenomowym mechanizmie działania GK zasadniczą rolę odgrywają interakcje z receptorami GK zlokalizowanymi w cytoplazmie, ale przede wszystkim w błonie komórkowej, które aktywują wiele szlaków sygnałowych kinaz (MAPK, Src, PI3K) i kanałów jonowych, a także szlaki sygnałowe związane z receptorami sprzężonymi z białkiem G. Udowodniono także przekaz sygnału bez udziału receptora dla GK. Odkrycie niegenomowego mechanizmu GK pozwala lepiej zrozumieć ich przeciwzapalne i immunosupresyjne działanie. Full article

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Open AccessArticle

Accuracy of Spirometry Performed by General Practitioners and Pneumonologists in the Pomeranian Region in the ‘COPD Prevention’ NHF Programme

by Krzysztof Kuziemski, Wojciech Słomiński, Krzysztof Specjalski, Ewa Jassem, Renata Kalicka and Jan Marek Słomiński

Adv. Respir. Med. 2009, 77(4), 380-386; https://doi.org/10.5603/ARM.27790 - 26 Jun 2009

Viewed by 283

Abstract

Introduction: Spirometry is the key test in diagnosing and severity assessment of chronic obstructive pulmonary disease (COPD). Despite the simplicity of the test, the discrepancy between results obtained by general practitioners and specialists is noted, what may lead to under- or overestimating of [...] Read more.

Introduction: Spirometry is the key test in diagnosing and severity assessment of chronic obstructive pulmonary disease (COPD). Despite the simplicity of the test, the discrepancy between results obtained by general practitioners and specialists is noted, what may lead to under- or overestimating of COPD prevalence. The aim of the study was to evaluate the quality of spirometry testing and interpretation performed by general practitioners and pulmonologists. Material and methods: Physicians from 56 healthcare units in the region of Pomerania were included. The participants (both GPs and pulmonologists) were trained in methodology and interpretation of spirometry tests. Then they were asked to choose 10 spirograms and send them for evaluation. Presence of patients’ personal details and signature of staff member, contents of graphs and tables, accuracy of the test and correctness of interpretation were evaluated. In statistical analysis c-square test was used. Results: The response from 14 healthcare units was received including 142 spirograms from GPs and 80 from pulmonologists. All spirograms contained personal details, gender, age, body weight and height as well as results of spirometry in form of tables and diagrams with predicted and measured values. Pulmonologists signed the spirograms more often than GPs (91% v. 77%, p < 0.001) and more often presented results of properly performed tests (75% v. 45%, p < 0.0001). However, in their group there were more interpretation errors (73% v. 91%, p < 0.05). Methodological mistakes revealed during the study were usually: too short and not enough dynamic inspiration and expiration. In some cases spirograms with expiration lasting 1.3 s were considered normal. The most common interpretation mistakes included: diagnosis of mixed-type ventilatory defects, wrong classification of obstruction level and lack of interpretation. In two cases result was found to be normal despite the lack of forced expiratory volume in one second value. Conclusions: The results indicate the necessity of continuous training in spirometry testing and interpretation by both general practitioners and specialists and nurses. Full article

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Open AccessArticle

Medical Students’ Attitudes towards Tobacco Smoking at the First and Sixth Year of Their Studies 2002–2008

by Alicja Siemińska, Joanna M. Jassem-Bobowicz, Maja Uherek, Tomasz Wilanowski, Radosław Nowak and Ewa Jassem

Adv. Respir. Med. 2009, 77(4), 371-379; https://doi.org/10.5603/ARM.27789 - 26 Jun 2009

Cited by 4 | Viewed by 312

Abstract

Introduction: The prevalence of smoking among medical students indicates that studying medicine is an insufficient protection from tobacco use. The aim of the study was an analysis of medical students’ attitudes towards smoking at the first and sixth year of their studies. Material [...] Read more.

Introduction: The prevalence of smoking among medical students indicates that studying medicine is an insufficient protection from tobacco use. The aim of the study was an analysis of medical students’ attitudes towards smoking at the first and sixth year of their studies. Material and methods: A questionnaire on tobacco smoking was distributed among medical students of the study year 2002–2008 at the first and sixth year of their studies. The questionnaire used on the sixth year students included additional questions designed to assess changes in their attitudes towards smoking during their studies, to ask their opinion of the teaching of diagnostics and treatment of tobacco dependence (TD), and to discover how they evaluated their knowledge of the issue. The numbers of students who participated at the two points of the study were 287 and 175 respectively. Results: Students in their sixth year significantly less frequently smoked cigarettes regularly than those starting their medical education (13% v. 21%; p = 0.022). However, 20% of smokers started smoking during their studies. The proportion of smokers saying they were not embarrassed by their smoking habit was significantly lower among sixth-year students compared to first-year students (31% v. 70%; p = 0.0006), as were the numbers who said they wanted to quit smoking (91% v. 61%). Those who wished to undergo treatment for TD (54% v. 22%) were significantly higher among sixth year students group (p = 0.013 and p = 0.001, respectively). More than half (57%) the sixth-year students claimed that they had no knowledge of the diagnostics and treatment of TD, or that their knowledge on this issue was poor or very poor. In the opinion of 43% of students, the medical curriculum was not a good source of knowledge on TD. Conclusions: Medical studies induce positively students’ attitudes towards smoking. However, a proportion of individuals start smoking during studies, which may suggest dominance of genetic influences on smoking initiation in this period of life. In sixth-year students’ opinion, medical studies are not a sufficient source of knowledge on TD. Full article

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Open AccessArticle

The Effects of Frequent Nurse Visits on Patient’s Compliance with Long-Term Oxygen Therapy (LTOT). A 14-Month Follow-Up

by Jacek Nasiłowski, Tadeusz Przybyłowski, Joanna Klimiuk, Artur Leśkow, Katarzyna Orska and Ryszarda Chazan

Adv. Respir. Med. 2009, 77(4), 363-370; https://doi.org/10.5603/ARM.27788 - 26 Jun 2009

Cited by 2 | Viewed by 319

Abstract

Introduction: Long-term oxygen therapy (LTOT) is the only treatment that improves prognosis in patients with chronic respiratory failure in the course of chronic obstructive pulmonary disease (COPD). This effect depends on the duration of oxygen use during the day and night. The aim [...] Read more.

Introduction: Long-term oxygen therapy (LTOT) is the only treatment that improves prognosis in patients with chronic respiratory failure in the course of chronic obstructive pulmonary disease (COPD). This effect depends on the duration of oxygen use during the day and night. The aim of this study was to evaluate the daily use of oxygen concentrator and to analyze factors that promote patient compliance. Material and methods: The study enrolled patients seen at the Long-Term Oxygen Therapy Center of the Department of Internal Medicine, Pneumology and Allergology, Medical University of Warsaw, Poland. Qualification for LTOT was in accordance with the guidelines of the Polish Respiratory Society and the European Respiratory Society (ERS). All patients were instructed to use oxygen therapy for at least 15 hours a day using a stationary oxygen concentrator. The duration of oxygen concentrator use was evaluated on the basis of the concentrator counter reading performed by visiting nurses. The visits were run on the monthly basis. Results: The study group involved 30 subjects (77% of COPD patients). The mean age was 67 ± 9 years, mean FEV₁ was 46 ± 18% predicted, RV/TLC was 64 ± 16% and PaO₂ was 50 ± 6 mm Hg. The mean duration of the daily oxygen therapy for the entire study group was 12.5 ± 4.6 hours. Eleven (37%) patients complied with the treatment during the follow-up period with the mean duration of daily oxygen therapy 17.4 ± 2.6 hours. The mean oxygen therapy use in the non-compliant group of patients averaged 9.6 ± 2.7 hours. We found that highest percentage of patients (48%) used oxygen for an appropriate period of time in the # first month of the treatment. The second month the number decreased to about 30% and remained at this level until the end of the follow-up period. The analysis of the COPD patients showed that in case of the compliant subjects the values of total lung capacity (TLC) (100 ± 19% predicted v. 152 ± 36% predicted, p = 0.001) and PaCO₂ (38 ± 6 mm Hg v. 47 ± 8 mm Hg, p < 0.05) were significantly lower in comparison to the group of patients who used the oxygen therapy for less than 15 hours a day. Fourteen (47%) patients reported a considerable increase in electricity consumption and seven (23%) patients complained about the noise of the oxygen concentrator. The daily oxygen use of this group was significantly lower in comparison to the patients who were not annoyed with the sound of the concentrator (9.0 ± 3.7 h/24 h v. 13.5 ± 4.4 h/24 h, p = 0.02). Conclusions: Our study show that the patients’ compliance was the highest during the first month of the treatment only, and that the monthly home visit did not influence the patients’ self-discipline to use LTOT properly. The use of an alternative source of oxygen, such as liquid oxygen, which would not generate any noise or electricity consumption, may positively influence the patient’s compliance. Full article

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Open AccessArticle

Endoscopic Ultrasound-Guided Needle Aspiration in Lung Cancer

by Artur Szlubowski, Marcin Zieliński, Joanna Figura, Jolanta Hauer, Witold Sośnicki, Juliusz Pankowski, Anna Obrochta and Magdalena Jakubiak

Adv. Respir. Med. 2009, 77(4), 357-362; https://doi.org/10.5603/ARM.27787 - 26 Jun 2009

Viewed by 320

Abstract

Introduction: The aim of the study was to assess the diagnostic yield of transoesophageal endoscopic ultrasound-guided needle aspiration (EUS-NA) in lung cancer (LC). Material and methods: Real time EUS-NA was performed under local anaesthesia and sedation in consecutive LC patients. All negative EUS-NA [...] Read more.

Introduction: The aim of the study was to assess the diagnostic yield of transoesophageal endoscopic ultrasound-guided needle aspiration (EUS-NA) in lung cancer (LC). Material and methods: Real time EUS-NA was performed under local anaesthesia and sedation in consecutive LC patients. All negative EUS-NA results in NSCLC patients were verified by transcervical extended bilateral mediastinal lymphadenectomy (TEMLA). Results: In 146 patients there were 206 biopsies performed in lymph node stations: subcarinal (7):124, left lower paratracheal (4L):70, paraoesophageal (8):9 and pulmonary ligament (9):3. A mean short axis of punctured node was 10 ± 6.3 (95% CI) mm. Lymph node biopsy was technically successful in 95.6% and was diagnostic in 40.1% of LC patients. In NSCLC staging, the sensitivity of EUS-NA calculated on the per-patient basis was 85.5%, specificity 100%, accuracy 93.6% and negative predictive value (NPV) 89.7% in stations accessible for EUS-NA, but in all mediastinal stations it was 70.7%, 100%, 84.3% and 74.7, respectively (p = 0.009). The sensitivity of EUS-NA in NSCLC staging patients, calculated on the per-biopsy basis was 88.6%, specificity 100%, accuracy 95.4% and NPV 91.4%. A diagnostic yield of EUS-NA on the per-biopsy basis was higher for station 4L than 7, but the difference was not significant (χ² p = 0.4). Conclusions: The diagnostic value of EUS-NA in LC is high. In NSCLC staging EUS-NA is insufficient and should be complemented by other invasive techniques, especially those that give access to the right paratracheal region. Full article

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Open AccessArticle

The Usefulness of Induced Sputum Examination in the Diagnostic Evaluation of Selected Chronic Inflammatory Diseases of the Respiratory Tract

by Ewa Sozańska, Adam Barczyk, Marta Biedroń-Machura and Władysław Pierzchała

Adv. Respir. Med. 2009, 77(4), 349-356; https://doi.org/10.5603/ARM.27786 - 26 Jun 2009

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Abstract

Introduction: Based on the normal values for inflammatory cell counts in induced sputum produced by healthy individuals living in the region of Silesia, Poland, we assessed the usefulness of cytological examination of induced sputum in the diagnostic evaluation of asthma, chronic obstructive pulmonary [...] Read more.

Introduction: Based on the normal values for inflammatory cell counts in induced sputum produced by healthy individuals living in the region of Silesia, Poland, we assessed the usefulness of cytological examination of induced sputum in the diagnostic evaluation of asthma, chronic obstructive pulmonary disease (COPD) and chronic bronchitis. Material and methods: We analyzed the results of examinations performed in 96 healthy individuals (controls), 42 patients with asthma, 49 with COPD and 30 with chronic bronchitis. We performed spirometry with salbutamol reversibility testing and examination of induced sputum in all the subjects. Those without contraindications underwent methacholine challenge testing. Results: We found a significantly elevated percentage of eosinophils in all the patient groups compared to the controls (p < 0.00001). Median values were 10.3% for asthma, 1.5% for COPD, 1.6% for chronic bronchitis and 0.3% for the controls. We found statistically significant differences in the mean neutrophil percentages in induced sputum between healthy individuals and asthma patients, COPD patients and chronic bronchitis patients (p < 0.05). The median values were 45.75%, 38.1%, 77.5% and 58.1%, respectively. The percentage of subjects with positive eosinophil counts (>2.8%) in the sputum of patients with asthma, COPD, chronic bronchitis and in the controls was 85%, 38%, 20% and 6%, respectively. Conclusions: 1. Cytological examination of induced sputum is a good test supporting the diagnostic evaluation of chronic inflammatory diseases of the respiratory tract. 2. The percentage of eosinophils in induced sputum exceeding 2.8% is a very good indicator of asthma. Full article

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Adv. Respir. Med., Volume 77, Issue 4 (June 2009) – 14 articles , Pages 349-430

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