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Advances in Respiratory Medicine is published by MDPI from Volume 90 Issue 4 (2022). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Via Medica.

Adv. Respir. Med., Volume 81, Issue 1 (January 2013) – 11 articles , Pages 1-88

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170 KiB  
Review
Postępy w Pneumonologii w 2012 Roku
by Ewa Augustynowicz-Kopeć, Iwona Bestry, Maria Korzeniewska-Koseła, Jan Kuś, Ilona Michałowska, Lucyna Opoka, Elżbieta Radzikowska, Witold Tomkowski and Jan Zieliński
Adv. Respir. Med. 2013, 81(1), 73-88; https://doi.org/10.5603/ARM.27532 - 13 Dec 2012
Viewed by 218
Abstract
Przewlekła obturacyjna choroba płuc (POChP) jest trzecią lub czwartą przyczyną zgonu na świecie po nowotworach, chorobach serca i naczyń oraz (w niektórych krajach) śmierci z przyczyn gwałtownych. Wszelkie aspekty choroby od jej patogenezy do paliatywnej opieki pod koniec życia są przedmiotem badań bardzo [...] Read more.
Przewlekła obturacyjna choroba płuc (POChP) jest trzecią lub czwartą przyczyną zgonu na świecie po nowotworach, chorobach serca i naczyń oraz (w niektórych krajach) śmierci z przyczyn gwałtownych. Wszelkie aspekty choroby od jej patogenezy do paliatywnej opieki pod koniec życia są przedmiotem badań bardzo licznych zespołów naukowców [...] Full article
300 KiB  
Case Report
Guzkowy Rozrost Limfoidalny—Rzadki Przypadek Choroby Limfoproliferacyjnej w Płucach
by Paweł Rogoziński, Krzysztof Bruliński, Eugeniusz Malinowski, Piotr Wandzel and Marek Kucharzewski
Adv. Respir. Med. 2013, 81(1), 68-72; https://doi.org/10.5603/ARM.27529 - 13 Dec 2012
Viewed by 319
Abstract
Nodular lymphoid hyperplasia (NLH) belongs to a very rare, mild, lymphoproliferative disease of unestablished aetiology historically included in the group of pseudolymphomas. Its existence was controversial for many years, until modern techniques of pathomorphological diagnosis approved it as a separate entity of lung [...] Read more.
Nodular lymphoid hyperplasia (NLH) belongs to a very rare, mild, lymphoproliferative disease of unestablished aetiology historically included in the group of pseudolymphomas. Its existence was controversial for many years, until modern techniques of pathomorphological diagnosis approved it as a separate entity of lung disease. It manifests in the form of well limited nodules localized in the lungs, which are mostly identified accidentally. Clinical symptoms are rare and nonspecific; the disease usually occupies only one lung. Pathomorphological diagnosis requires immunohistochemical designation of expressions of numerous antigens in order to exclude malignant lymphoma of the lungs. Surgical resection is used in cases of larger nodules; the smaller ones require periodic observation, and the prognosis is good. The authors describe the case of 65-year-old woman with pulmonary nodules which were detected accidentally in the right lung. The patient was qualified for right-sided videothoracoscopy and removal of the lung nodule. In classic HE staining of the histological material, the presence of lymphoid infiltration of the lungs was revealed, which formed lymph follicles with reactive germinal centres. In order to differentiate from the malignant lymphatic expansion, immunohistochemical designations were made, which showed positive expression of CD20 antigen in the B cell zone, positive expression of the CD3 antigen in the T cells zone, positive expression of CD23 antigen in the lymph follicles, negative expression of bcl-2 in the lymph follicles, and positive expression of MIB-1 in the germinal centres of lymph follicles. Such a histopathological and immunohistochemical picture provided the basis for diagnosis of nodular lymphoid hyperplasia of the lung. Full article
307 KiB  
Case Report
Pneumocystozowe Zapalenie Płuc u Chorej na Limfangioleiomiomatozę
by Tomasz Mydłowski, Elżbieta Radzikowska, Karina Oniszh, Ewa Szczepulska-Wójcik, Paulina Jaguś and Elżbieta Wiatr
Adv. Respir. Med. 2013, 81(1), 61-67; https://doi.org/10.5603/ARM.27528 - 13 Dec 2012
Viewed by 278
Abstract
A 47-year-old, non-smoking woman was admitted to the National Tuberculosis and Lung Diseases Research Institute for diagnosis of progressive exertional dyspnoea and numerous small thin-walled, air-filled cysts equally distributed throughout both lungs revealed in HRCT (high resolution computed tomography) examination. Histological assessment of [...] Read more.
A 47-year-old, non-smoking woman was admitted to the National Tuberculosis and Lung Diseases Research Institute for diagnosis of progressive exertional dyspnoea and numerous small thin-walled, air-filled cysts equally distributed throughout both lungs revealed in HRCT (high resolution computed tomography) examination. Histological assessment of specimens obtained by open lung biopsy revealed proliferation of immature smooth muscle, showing the expression of the antigen HMB45. On this basis, diagnosis of lymphangioleiomyomatosis was established. The disease caused essential ventilation damage of the lungs (FEV1 1.34 L; 39.71% pred, VC 4.02 L; 94.96% pred, FEV1/ /VC 0.33–4 1.81% pred, DLCO 3.65 mmol/min/Kpa 38.35% pred).During the observation, despite the lack of immunological disorders, the patient developed Pneumocystis jiroveci pneumonia (PCP) that was treated with trimethoprimsulfamethoxazole. Lymphangioleiomyomatosis is a rare disease which results from a defect of TSC genes. The disease is not related to immunological defects or disorders. However, the considerable cystic destruction of the lungs can predispose the patient to opportunistic infections such as the one in the presented case. Full article
103 KiB  
Review
Leczenie Zaawansowanego Niedrobnokomórkowego Raka Płuca—W Którym Miejscu Jesteśmy?
by Janusz Milanowski and Katarzyna Szmygin-Milanowska
Adv. Respir. Med. 2013, 81(1), 55-62; https://doi.org/10.5603/ARM.27531 - 13 Dec 2012
Cited by 1 | Viewed by 345
Abstract
Lung cancer is the most common cancer in Poland and in the world, unfortunately diagnosed too late, and combined with a very poor prognosis. For most patients with NSCLC the only possibility of treatment is palliative therapy, including chemotherapy and, in the recent [...] Read more.
Lung cancer is the most common cancer in Poland and in the world, unfortunately diagnosed too late, and combined with a very poor prognosis. For most patients with NSCLC the only possibility of treatment is palliative therapy, including chemotherapy and, in the recent years, molecular targeted therapy. In first-line treatment, cisplatine-based “doublets” are most effective, and in second-line, pemetreksed and docetaxel are used. Recently, maintenance chemotherapy has been introduced. Although standard chemotherapy improves the quality of life in the patients with advanced NSCLC, due to significant toxicity such treatment should be applied only in patients in good performance status. The introduction of targeted therapy, based on the molecular profile of the patient has allowed the management to be personalized, which may result in more effective treatment and may be safer for the patient. Full article
153 KiB  
Review
Genetyczne Warianty alfa-1 Antytrypsyny—Klasyfikacja i Znaczenie Kliniczne
by Beata Popławska, Sabina Janciauskiene and Joanna Chorostowska-Wynimko
Adv. Respir. Med. 2013, 81(1), 45-54; https://doi.org/10.5603/ARM.27530 - 13 Dec 2012
Cited by 1 | Viewed by 258
Abstract
Inherited alpha-1 antitrypsin deficiency is listed among the three most common genetic disorders in Caucasians. It considerably increases the risk of progressive obstructive lung diseases, mostly chronic obstructive pulmonary disease, as well as chronic liver disorders, hepatitis, cirrhosis, and cancer. It is estimated [...] Read more.
Inherited alpha-1 antitrypsin deficiency is listed among the three most common genetic disorders in Caucasians. It considerably increases the risk of progressive obstructive lung diseases, mostly chronic obstructive pulmonary disease, as well as chronic liver disorders, hepatitis, cirrhosis, and cancer. It is estimated that more than 5.5% of the Polish population carries one of the most common deficiency phenotypes, which might be relatively easily detected due to low alpha-1 antitrypsin serum concentration. However, as well as being quantitative, alpha-1 antitrypsin deficiency might also be qualitative. These dysfunctional alpha-1 antitrypsin variants are characterized by scarce antiproteolytic activity and quite often by fully effective protein production resulting in normal serum levels. Consequently, dysfunctional variant identification is possible only by means of pheno- or genotyping. This review presents clinically useful characteristics of main genetic alpha-1 antitrypsin variants. Full article
123 KiB  
Article
Occult Bronchial Foreign Bodies—Analysis of Own Material
by Wojciech Szafrański, Jarosław Dobielski, Wojciech Papiewski and Urszula Czechowska
Adv. Respir. Med. 2013, 81(1), 40-44; https://doi.org/10.5603/ARM.27527 - 13 Dec 2012
Cited by 2 | Viewed by 317
Abstract
Introduction: The aspiration of a foreign body is usually combined with acute clinical symptoms requiring immediate medical intervention. Nevertheless, in approximately one third of patients the symptoms of aspiration are less prominent; such a clinical condition is called occult bronchial foreign body (OBFB). [...] Read more.
Introduction: The aspiration of a foreign body is usually combined with acute clinical symptoms requiring immediate medical intervention. Nevertheless, in approximately one third of patients the symptoms of aspiration are less prominent; such a clinical condition is called occult bronchial foreign body (OBFB). The aim of our study was to assess the frequency of OBFB in the pulmonary unit of a district hospital and to evaluate the diagnostic difficulties and treatment modalities in such patients. Material and methods: The examined group consisted of patients hospitalized in the Department of Lung Diseases in Radom District Hospital. A retrospective analysis of medical records was preformed. Results: In the period 1978–2008—12 patients (10 males, 2 females) were hospitalized due to OBFB. The foreign bodies occluded the bronchi over 2 months (3 to 7) in 4 patients. The moment of aspiration was not remembered by 8 patients. Cases of OBFB were rare. In the presented material the frequency was 4 per 10,000 hospitalizations and 8 per 10,000 bronchoscopies. In our region of 600,000 population the index of hospitalization due to OBFB in adults (>14 years of age) was 0.07 per 100,000 inhabitants/year. Foreign bodies mainly included bone fragments (5 cases), vegetal remnants—clove of garlic, ear of corn (3 patients), and other food remnants (2 patients). Occasionally other aspirates were found, such as a wooden peg or a piece of plastic. The aspiration took place mostly during meals. The patients developed one or more of the following symptoms: purulent pneumonia (3 cases), pleural empyema (1 case), atelectasis (5 cases), and recurrent bronchitis and pneumonia (2 cases). The foreign body (fragments of plants) was mimicking a bronchial tumour in 4 patients. Fibre optic or rigid bronchoscopy was applied successfully in 11 patients. Only one patient needed surgical intervention. Conclusions: OBFB is a rare condition, but has to be taken into consideration as a cause of chest radiological pathology and in patients with chronic and/or recurrent inflammatory disease of the respiratory system. Full article
123 KiB  
Article
Outcome after PET-CT Based Radiotherapy for Non-Small Cell Lung Cancer
by Joanna Socha, Milena Kołodziejczyk and Lucyna Kępka
Adv. Respir. Med. 2013, 81(1), 30-39; https://doi.org/10.5603/ARM.27526 - 13 Dec 2012
Cited by 2 | Viewed by 296
Abstract
Introduction: The value of PET-CT in radiotherapy for non-small cell lung cancer (NSCLC) with regard to determination of target volumes is established. It is less clear whether its use can improve clinical outcomes of irradiated NSCLC patients compared to conventional staging. The outcome [...] Read more.
Introduction: The value of PET-CT in radiotherapy for non-small cell lung cancer (NSCLC) with regard to determination of target volumes is established. It is less clear whether its use can improve clinical outcomes of irradiated NSCLC patients compared to conventional staging. The outcome of NSCLC patients included in a previously published prospective study of the value of PET-CT in curative radiotherapy candidates was assessed. Material and methods: Patients were treated according to the PET-CT findings. The survival data were compared between 67 patients treated curatively and 22 patients with palliative treatment given after upstaging based on the PET-CT findings. Survival of curatively treated stage III patients was compared with a previously published outcome of 173 stage III patients treated in the same institution with the same radiation schedule but without PET-CT. Results: The 3-year overall survival was 42% and 0% (median: 21 months and 7 months), for curatively and palliatively managed patients, respectively (p < 0.0001). However, the median overall survival of 17 months for 50 stage III patients was the same as that in a previously published series of stage III patients treated with the same radiation schedule but without PET-CT. Three-year overall survival rates were 33% for the PET-CT group and 19% for historical group, p = 0.1. Twenty-one local recurrences and 21 distant metastases were reported. Three of 50 patients (6%) treated without elective nodal irradiation developed isolated nodal failure (without local recurrence). Conclusions: The high early mortality rate in the patients excluded from curative radiotherapy after PET-CT suggests the potential value of PET-CT for improving the radiotherapy outcome. However, this benefit seems to be limited in stage III patients. Full article
118 KiB  
Article
Usefulness of NT-proBNP Serum Level in the Diagnosis of Dyspnea in COPD Patients
by Renata Rubinsztajn, Jacek Nasiłowski, Tadeusz Przybyłowski, Krzysztof Karwat and Ryszarda Chazan
Adv. Respir. Med. 2013, 81(1), 24-29; https://doi.org/10.5603/ARM.27525 - 13 Dec 2012
Cited by 2 | Viewed by 350
Abstract
Introduction: Cardiovascular diseases often coexist with chronic obstructive pulmonary disease (COPD), and in some cases it is difficult to differentiate between cardiac and pulmonary cause of dyspnoea. It is well known that the serum concentration of NT-proBNP in patients with cardiovascular diseases, especially [...] Read more.
Introduction: Cardiovascular diseases often coexist with chronic obstructive pulmonary disease (COPD), and in some cases it is difficult to differentiate between cardiac and pulmonary cause of dyspnoea. It is well known that the serum concentration of NT-proBNP in patients with cardiovascular diseases, especially with congestive heart failure, is elevated. The aim of this study was to estimate the usefulness of NT-proBNP serum level measurement in patients with COPD complaining of chronic dyspnoea. Material and methods: The study group consisted of 81 stable COPD patients in the mean age, 65 ± 7 years, (57 of them with concomitant cardiovascular disease). Serum concentration of NT-proBNP was measured using VITROS laboratory test. Results. There were no statistical differences in serum NT-proBNP between patients stratified according to the GOLD staging system for COPD severity or BODE index and mMRC breathlessness scale. The concentration of NT-proBNP was statistically significantly higher in the patients with coexisting cardiovascular diseases (220.8 ± 258.1 vs. 95.4 ± 56.1 pg/ml). The group of patients with NT-proBNP concentration > 125 pg/ml (n = 36) was statistically significantly older (67.5 ± 6 years old vs. 63.2 ± 7.1 years old; p = 0.009) and had statistically significantly lower PaO2 (67.4 ± 11.8 mm Hg vs. 73.0 ± 11.6 mm Hg; p = 0.04). Conclusions: 1. In the group of stable COPD patients there were no differences between NT-proBNP serum concentration according to GOLD staging, BODE index, and mMRC breathlessness scale. 2. The NT-proBNP serum concentration was statistically significantly higher in the group of COPD patients with the concomitant cardiovascular disease. 3. In patients with chronic dyspnoea testing of serum NT-proBNP may be useful in the detection of patients with cardiovascular problems, who require more intensive therapy. Full article
242 KiB  
Article
Clara Cell Protein and Myeloperoxidase Levels in Serum of Subjects after Exposure to Fire Smoke
by Anna Krakowiak, Tadeusz Hałatek, Ewa Nowakowska-Świrta, Renata Winnicka, Piotr Politański and Sylwia Świderska-Kiełbik
Adv. Respir. Med. 2013, 81(1), 16-23; https://doi.org/10.5603/ARM.27524 - 13 Dec 2012
Viewed by 247
Abstract
Introduction: Fire smoke inhalation is a well-recognized aetiological factor of airway injuries. The objective of this study was evaluation of Clara cell protein (CC16) and myeloperoxidase (MPO) concentrations in serum of patients after exposure to uncontrolled fire smoke. Methods: The study group consisted [...] Read more.
Introduction: Fire smoke inhalation is a well-recognized aetiological factor of airway injuries. The objective of this study was evaluation of Clara cell protein (CC16) and myeloperoxidase (MPO) concentrations in serum of patients after exposure to uncontrolled fire smoke. Methods: The study group consisted of 40 consecutive patients admitted to the Toxicology Unit after exposure to fire smoke. CC16 and MPO concentrations in their serum samples was measured on the day of admission to hospital and rechecked at the 2nd day and on the day of discharge. Patients also underwent routine toxicological diagnostic procedures applied in case of exposures, such as carboxyhaemoglobin (COHb) levels and blood lactate and urinary thiocyanate concentrations. The same diagnostic tests were performed in the control group consisting of 10 healthy subjects not exposed to fire smoke. Results: The average concentration of CC16 in the serum of subjects exposed to toxic factors was significantly higher at the day of admission in comparison with the respective values recorded on the 2nd day and on the day of discharge. The mean level of CC16 in the serum of the exposed group was also significantly higher than that in the control group. Tests for MPO concentrations in the serum did not reveal any significant changes in patients exposed to fire smoke. Conclusions: As indicated, acute exposure to smoke induces injury at the alveolar level, which results in a transient increase of CC16 in serum of exposed subjects. Full article
124 KiB  
Article
Staging of Non-Small Cell Lung Cancer Using CT and Integrated PET-CT
by Lucyna Opoka, Jolanta Kunikowska, Zbigniew Podgajny, Katarzyna Błasińska-Przerwa, Barbara Burakowska, Karina Oniszh, Magdalena Gola, Renata Langfort, Piotr Rudziński, Iwona Bestry and Kazimierz Roszkowski-Śliż
Adv. Respir. Med. 2013, 81(1), 5-15; https://doi.org/10.5603/ARM.27523 - 13 Dec 2012
Viewed by 304
Abstract
Introduction: Lung cancer is the leading cause of death from cancer in developed countries. Radiological imaging methods are the basic methods in early diagnosis of this disease. TNM classification is a very important tool for optimal treatment in non-small lung cancer (NSCLC). Conventional [...] Read more.
Introduction: Lung cancer is the leading cause of death from cancer in developed countries. Radiological imaging methods are the basic methods in early diagnosis of this disease. TNM classification is a very important tool for optimal treatment in non-small lung cancer (NSCLC). Conventional radiological techniques allow the evaluation of the stage on the basis of anatomical changes only, while PET-CT provides information about the biochemical processes that may precede anatomical changes. The aim of this study was to compare the accuracy and sensitivity of CT and PET-CT in the staging of NSCLC. Material and methods: The study was conducted on a group of 99 patients with NSCLC diagnosed at the National Tuberculosis and Lung Diseases Research Institute in the period from January 2008 to May 2010. CT and PET-CT were performed in all patients. Histological or cytological examination of the material obtained from biopsy, bronchoscopy, mediastinoscopy, and intraoperatively was the reference test. TNM classification was performed independently after CT and PET-CT. Results and conclusions: It has been shown that PET-CT is a more accurate and sensitive method than CT in the staging process in NSCLC. PET-CT allowed the correct classification of the T, N, M, and total TNM in, respectively, 97%, 95%, 99%, and 89% of cases, while for CT it was, respectively, 95%, 84%, 84%, and 68% (p = 0.0002). Full article
81 KiB  
Editorial
Aktywne Rozpoznawanie POChP w Grupach Wysokiego Ryzyka w Polsce w Latach 1999–2011, Co Dalej?
by Jan Zieliński
Adv. Respir. Med. 2013, 81(1), 1-4; https://doi.org/10.5603/ARM.27522 - 13 Dec 2012
Viewed by 212
Abstract
Przewlekła obturacyjna choroba płuc (POChP) jest przewlekłą, postępującą, trwającą kilkadziesiąt lat chorobą kończącą się zgonem z powodu powikłań, którymi najczęściej są: niewydolność oddychania i hipoksyjne nadciśnienie płucne (serce płucne) [...] Full article
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