Advances in Respiratory Medicine

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Open AccessObituary

Doktor medycyny Jerzy Włodzimierz Góralczyk (1934–2012)—Wspomnienie pośmiertne

by Józef Janczy and Marcin Zieliński

Adv. Respir. Med. 2013, 81(3), 281; https://doi.org/10.5603/ARM.34104 - 19 Apr 2013

Viewed by 348

Jerzy Włodzimierz Góralczyk urodził się 10 lutego 1934 roku w Krakowie. Studiował na Wydziale Lekarskim Akademii Medycznej w Krakowie w latach 1951–1957, uzyskując, po rocznym stażu w Szpitalu Miejskim w Cieszynie w 1957 roku, dyplom lekarza. W latach 1957–1959 pracował w Szpitalu Powiatowym [...] Read more.

Jerzy Włodzimierz Góralczyk urodził się 10 lutego 1934 roku w Krakowie. Studiował na Wydziale Lekarskim Akademii Medycznej w Krakowie w latach 1951–1957, uzyskując, po rocznym stażu w Szpitalu Miejskim w Cieszynie w 1957 roku, dyplom lekarza. W latach 1957–1959 pracował w Szpitalu Powiatowym w Żaganiu na oddziale ginekologiczno-położniczym [...] Full article

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Open AccessCase Report

Włóknienie śródpiersia z nadciśnieniem płucnym jako rzadkie powikłanie sarkoidozy

by Monika Załęska, Katarzyna Błasińska-Przerwa, Karina Oniszh, Barbara Roszkowska-Śliż and Kazimierz Roszkowski-Śliż

Adv. Respir. Med. 2013, 81(3), 273-280; https://doi.org/10.5603/ARM.34103 - 19 Apr 2013

Cited by 1 | Viewed by 341

Abstract

Włóknienie śródpiersia jest rzadką chorobą, która najczęściej wiąże się z przewlekłym procesem zapalnym przebiegającym z tworzeniem ziarniniaków głównie w przebiegu histoplazmozy, gruźlicy lub sarkoidozy. W prezentowanej pracy przedstawiono przypadek 42-letniej kobiety z sarkoidozą, u której w przebiegu choroby doszło do włóknienia śródpiersia i [...] Read more.

Włóknienie śródpiersia jest rzadką chorobą, która najczęściej wiąże się z przewlekłym procesem zapalnym przebiegającym z tworzeniem ziarniniaków głównie w przebiegu histoplazmozy, gruźlicy lub sarkoidozy. W prezentowanej pracy przedstawiono przypadek 42-letniej kobiety z sarkoidozą, u której w przebiegu choroby doszło do włóknienia śródpiersia i nadciśnienia płucnego. W tomografii komputerowej klatki piersiowej z kontrastem uwidoczniono nieprawidłowe, obustronne, lite masy tkankowe otaczające śródpiersie i wnęki. W rezonansie magnetycznym stwierdzono nieprawidłową tkankę w śródpiersiu, o pośrednim sygnale, ze wzmocnieniem kontrastowym, otaczającą wnęki, zwężającą obie tętnice dolnopłatowe i oskrzela płatowe, niedodmę płata górnego lewego. U chorej podjęto próbę leczenia steroidami (1 mg/kg w stopniowo zmniejszanej dawce przez 14 mies.), uzyskując poprawę kliniczną, przy częściowej regresji zmian radiologicznych. W doniesieniu dokonano przeglądu piśmiennictwa na temat włóknienia śródpiersia i na tej podstawie omówiono jego różnorodne przyczyny, diagnostykę radiologiczną i ewentualne próby leczenia. Kolejnym problemem poruszanym w pracy było nadciśnienie płucne obserwowane u opisywanej pacjentki, które mogło być związane zarówno z włóknieniem śródpiersia, jak i sarkoidozą. Full article

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Open AccessCase Report

Ciężka hipoksemiczna niewydolność oddechowa u chorego z zespołem wątrobowo-płucnym i chorobą śródmiąższową płuc o nieznanej etiologii

by Katarzyna Gorzkowska-Pasik, Elżbieta Wiatr, Barbara Burakowska, Urszula Nowicka, Jarosław Kober, Przemysław Malong, Piotr Pasik and Krystyna Folcik

Adv. Respir. Med. 2013, 81(3), 267-272; https://doi.org/10.5603/ARM.34106 - 19 Apr 2013

Viewed by 363

Abstract

Hipoksemiczna niewydolność oddechowa u chorego z cechami choroby śródmiąższowej jest rzadko kojarzona z przyczyną pozapłucną. U chorych na marskość wątroby hipoksemia może być manifestacją zespołu wątrobowo-płucnego, jednak zmiany w badaniu radiologicznym klatki piersiowej stwierdzane w przebiegu tego zespołu mają zwykle charakter naczyniowy, a [...] Read more.

Hipoksemiczna niewydolność oddechowa u chorego z cechami choroby śródmiąższowej jest rzadko kojarzona z przyczyną pozapłucną. U chorych na marskość wątroby hipoksemia może być manifestacją zespołu wątrobowo-płucnego, jednak zmiany w badaniu radiologicznym klatki piersiowej stwierdzane w przebiegu tego zespołu mają zwykle charakter naczyniowy, a więc nie są zaliczane do typowych chorób śródmiąższowych. W pracy przedstawiono przypadek chorego z ciężką hipoksemiczną niewydolnością oddechową, u którego rozpoznano jednoczasowo zespół wątrobowo-płucny i chorobę śródmiąższową płuc o nieustalonej etiologii. W dyskusji omówiono mechanizmy hipoksemii w przebiegu niewydolności wątroby oraz spektrum chorób dotyczących płuc i wątroby przebiegających z hipoksemią. Full article

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Open AccessReview

Benefits of Oxygen on Exercise Performance in Patients with Chronic Lung Diseases

by Jacek Nasiłowski

Adv. Respir. Med. 2013, 81(3), 259-266; https://doi.org/10.5603/ARM.34101 - 19 Apr 2013

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Abstract

Chronic respiratory diseases limit exercise capacity, due to breathlessness and hypoxemia. A decrease in daily activity results in impairment of quality of life and higher mortality. Oxygen therapy improves exercise capacity. The main mechanism of this improvement in COPD patients is a reduction [...] Read more.

Chronic respiratory diseases limit exercise capacity, due to breathlessness and hypoxemia. A decrease in daily activity results in impairment of quality of life and higher mortality. Oxygen therapy improves exercise capacity. The main mechanism of this improvement in COPD patients is a reduction in dynamic hyperinflation. The benefits of oxygen therapy is present not only in patients with severe hypoxemia at rest (PaO₂ < 60 mm Hg) requiring long-term oxygen therapy, but also in mild hypoxemic patients who develop desaturation during exercise. An improvement in exercise tolerance is proportional to the administered oxygen flow. Provision of oxygen flow from ambulatory source may be continuous or intermittent only during inspiration. Both methods seem to be comparable in terms of improving exercise tolerance and reducing hypoxemia. Ambulatory oxygen should be prescribed to all patients on long-term oxygen therapy who report outdoor activity. Moreover, normoxemic patients with severe exertional desaturation and low exercise tolerance should also be prescribed ambulatory oxygen. The flow of oxygen should be titrated to prevent desaturation during activities. The long-term effects of ambulatory oxygen such as improvement of quality of life and increasing daily activity have not been confirmed and require further investigation. Full article

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Open AccessGuidelines

Zalecenia Polskiego Towarzystwa Chorób Płuc Dotyczące Rozpoznawania i Leczenia Zaburzeń Oddychania w Czasie snu (ZOCS) u Dorosłych

by Robert Pływaczewski, Anna Brzecka, Piotr Bielicki, Małgorzata Czajkowska-Malinowska, Szczepan Cofta, Luiza Jonczak, Jakub Radliński, Maciej Tażbirek and Jolanta Wasilewska

Adv. Respir. Med. 2013, 81(3), 221-258; https://doi.org/10.5603/ARM.34100 - 19 Apr 2013

Cited by 4 | Viewed by 570

Abstract

Sen jest stanem fizjologicznym, w którym człowiek spędza około jednej trzeciej życia—niezbędnym dla prawidłowego funkcjonowania organizmu [...] Full article

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Open AccessArticle

Assessment of Recurrence of Non-Small Cell Lung Cancer after Therapy Using CT and Integrated PET/CT

by Lucyna Opoka, Małgorzata Szołkowska, Zbigniew Podgajny, Jolanta Kunikowska, Inga Barańska, Katarzyna Błasińska-Przerwa, Lilia Jakubowska, Piotr Rudziński, Iwona Bestry and Kazimierz Roszkowski-Śliż

Adv. Respir. Med. 2013, 81(3), 214-220; https://doi.org/10.5603/ARM.34099 - 19 Apr 2013

Cited by 1 | Viewed by 319

Abstract

Introduction: Non-small cell lung cancer (NSCLC) has become the leading cause of cancer-related deaths in Poland. Follow-up of patients with NSCLC is aimed at early detection of local recurrence, metastatic process, treatment-related complications or second primary lung cancer. We investigated the diagnostic [...] Read more.

Introduction: Non-small cell lung cancer (NSCLC) has become the leading cause of cancer-related deaths in Poland. Follow-up of patients with NSCLC is aimed at early detection of local recurrence, metastatic process, treatment-related complications or second primary lung cancer. We investigated the diagnostic accuracy of FDG-PET-CT in the detection of recurrence of NSCLC after treatment. Material and methods: Seventy-two NSCLC patients (19 females, 56 males), stage I to IV, who had undergone surgery and/ /or radiation therapy, occasionally associated with chemotherapy, were retrospectively included in our study. Chest radiographs and thoracic computed tomography (CT) were performed to localize the abnormality prior to PET-CT. All the patients underwent CT and PET-CT in the period from January 2008 until January 2012. All PET images were interpreted in conjunction with thoracic CT. PET-CT and CT diagnoses were correlated with pathological diagnoses. Results: Forty-five patients had recurrent tumour. Tumour recurrence was observed more often in men than in women and also in case of neoplastic cell emboli in lymphatic or blood vessels. In three patients second primary lung cancer was diagnosed. False positive diagnosis of relapse based on PET-CT was obtained in 4 patients, mainly due to inflammatory lesions. The accuracy of PET-CT for diagnosis of recurrence was 94.4% (95% CI 91; 100). Conclusions: FDG PET-CT was the best method to differentiate recurrent bronchogenic carcinoma from inflammatory lesions, especially at post-therapeutic sites. It has been shown that PET-CT is more accurate method than CT in recurrent NSCLC. PET-CT results had a further impact on the clinical management and treatment planning. Full article

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Open AccessArticle

Polymorphism of the ACE Gene and the Risk of Obstructive Sleep Apnoea

by Izabela Chmielewska, Radosław Mlak, Paweł Krawczyk, Ewa Czukiewska and Janusz Milanowski

Adv. Respir. Med. 2013, 81(3), 207-213; https://doi.org/10.5603/ARM.34098 - 19 Apr 2013

Viewed by 269

Abstract

Introduction: Obstructive sleep apnoea/hypopnea syndrome (OSA) is characterized by obstruction of the upper airway during sleep, resulting in repetitive breathing pauses accompanied by oxygen desaturation and arousal from sleep. Among the candidate genes affecting the risk of OSA, genes whose polymorphisms influence [...] Read more.

Introduction: Obstructive sleep apnoea/hypopnea syndrome (OSA) is characterized by obstruction of the upper airway during sleep, resulting in repetitive breathing pauses accompanied by oxygen desaturation and arousal from sleep. Among the candidate genes affecting the risk of OSA, genes whose polymorphisms influence the development of diseases with similar pathogenesis such as OSA could be listed: APOE, genes for leptin and leptin receptor, TNFA1, ADRB2 and ACE (gene for angiotensin-converting enzyme). Until now there has been a confirmed relationship between ACE gene polymorphism and cardiovascular diseases, but its effect on the incidence of OSA is debatable. The aim of this study was to investigate the effect of ACE gene insertion/deletion (I/D) polymorphism on the risk of OSA. Material and methods: Fifty-five patients with confirmed diagnose of OSA and qualified to CPAP therapy entered the study. The control group included 50 subjects who did not complain of any sleep related symptoms. Diagnose of OSA was set on the basis of full overnight polysomnography together with Epworth Sleepiness Scale according to American Academy of Sleep Medicine guidelines. DNA was isolated from peripheral blood leukocytes with Qiagen DNA mini Kit. ACE gene polymorphism was determined in genomic DNA using allele specific polymerase chain reaction. Different sizes of PCR products were observed on agarose gel electrophoresis. Results: There were non-significant differences in the frequency of ACE genotypes. However, allele D had significantly lower prevalence in the study group than in the control group. (χ² = 4.25 p = 0.04). Moreover, I allele carriers had a threefold greater risk of developing OSA (HR = 2.748, 95% CI = 1.029–7.340, p < 0.05). Conclusions: Analysis of ACE gene polymorphism might be useful to determine the risk of developing OSA in clinically predisposed patients. Full article

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Open AccessArticle

Impact of Mild Anaemia on Dyspnoea during Exertion and Exercise Tolerance in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

by Adam Nowiński, Dariusz Kamiński, Marek Kram, Damian Korzybski, Anna Stokłosa and Dorota Górecka

Adv. Respir. Med. 2013, 81(3), 200-206; https://doi.org/10.5603/ARM.34097 - 19 Apr 2013

Cited by 2 | Viewed by 295

Abstract

Introduction: Dyspnoea and decreased exercise tolerance are symptoms of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Anaemia is a risk factor for reduced functional capacity and dyspnoea in stable COPD. There is limited information about the impact of anaemia on functional [...] Read more.

Introduction: Dyspnoea and decreased exercise tolerance are symptoms of acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Anaemia is a risk factor for reduced functional capacity and dyspnoea in stable COPD. There is limited information about the impact of anaemia on functional capacity and dyspnoea of patients during AECOPD. The aim of this study was to evaluate the impact of decreased blood haemoglobin concentration on the results of six-minute walking test (6MWT) in patients during AECOPD. Material and methods: A post hoc analysis of data collected from prospective long-term studies on AECOPD. Haemoglobin concentration from the first obtainable hospital measurement were included in the assessment. 6MWT was performed after clinical improvement of the patient. Dyspnoea at baseline and after exercise and oxygen saturation (SpO₂) during exercise was measured. Results: (presented as means ± SD): 402 patients with exacerbation of COPD (COPD stage 3.5 ± 0.6) were examined. Patients with anaemia (26% of those studied, age 74.5 ± 8.2 years) achieved 258.1 ± 125.1 m during 6MWT, with exertional desaturation of 2.9 ± 2.6%. Patients without anaemia (74% of those studied, age 70.2 ± 8.7 years) achieved 271 ± 136.0 m during 6MWT with exertional desaturation of 3.8 ± 3.7%. The haemoglobin concentration did not correlate with 6MWT, dyspnoea during 6MWT, or exercise oxygenation and blood desaturation during exercise. Conclusion: Mildly decreased blood haemoglobin concentration did not influence the results of 6MWT in patients with AECOPD. Full article

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Open AccessArticle

Cellular Composition of Induced Sputum in Sarcoidosis

by Maria Porzezińska, Wanda Knopińska-Posłuszny, Bogumiła Cynowska and Jan Marek Słomiński

Adv. Respir. Med. 2013, 81(3), 192-199; https://doi.org/10.5603/ARM.34105 - 19 Apr 2013

Cited by 1 | Viewed by 247

Abstract

Introduction: The aim of this study was to evaluate the cellular composition of induced sputum (IS) in sarcoidosis and its role in assessing the disease activity. The safety of the procedure was also determined. Material and methods: Sputum induction by inhalation [...] Read more.

Introduction: The aim of this study was to evaluate the cellular composition of induced sputum (IS) in sarcoidosis and its role in assessing the disease activity. The safety of the procedure was also determined. Material and methods: Sputum induction by inhalation of hypertonic saline was performed. Twenty-one samples from the healthy controls, 32 from patients with active disease, and 33 from subjects with inactive disease were analysed. Results: The percentage of lymphocytes in IS was significantly higher in active sarcoidosis than in inactive disease and the control group (9.7% vs. 3.1% vs. 2.9%), and was the highest in the patients with parenchymal changes and active disease (13.3%). The percentage of macrophages was significantly lower in active sarcoidosis than in normal subjects (76.8% vs. 83.4%). It was also significantly lower in IS in active disease and stages II and III than in both subgroups with active and inactive stage I of sarcoidosis. There were no significant differences in the IS cell percentages between the whole sarcoidosis group and the controls. Sputum induction was well tolerated and stopped only four times, two of them because of dyspnoea or the decrease of PEF. The symptoms were well reversible after administering salbutamol. Conclusions: Sputum induction by inhalation of hypertonic saline is safe, but the evaluation of IS differential cell counts is not useful in sarcoidosis diagnosing. However, it could be used in assessing the activity of the disease, especially in patients with interstitial lung changes. Full article

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Open AccessEditorial

Nadciśnienie Płucne w Przebiegu Chorób Płuc—Jdna czy Wiele Przyczyn?

by Monika Szturmowicz

Adv. Respir. Med. 2013, 81(3), 187-191; https://doi.org/10.5603/ARM.34095 - 19 Apr 2013

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Abstract

Nadciśnienie płucne występujące w przebiegu chorób płuc (PH-LD, pulmonary hypertension asso-ciated with lung diseases) stanowi istotny problem diagnostyczny i terapeutyczny [...] Full article

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Adv. Respir. Med., Volume 81, Issue 3 (April 2013) – 10 articles , Pages 187-281

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