Advances in Respiratory Medicine

108 KiB

Open AccessLetter

Basophil Activation Test—Brief Comment and Response

by Marika Gawinowska

Adv. Respir. Med. 2015, 83(3), 245-246; https://doi.org/10.5603/PiAP.2015.0041 - 30 Apr 2015

Viewed by 308

There is no doubt that during performance basophil activation test (BAT) many factors influencing the procedure must be taken under consideration [...] Full article

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Open AccessLetter

Basophil Activation Tests (BAT): Wheat and Chaff

by Salvatore Chirumbolo

Adv. Respir. Med. 2015, 83(3), 243-244; https://doi.org/10.5603/PiAP.2015.0040 - 30 Apr 2015

Viewed by 292

Abstract

The recent article by Gawinowska et al., on the latest issue of “Polish Pneumology and Allergology” addressed the issue of the application of basophil activation test (BAT) in the diagnosis of drug hypersensitivity [...] Full article

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Open AccessLetter

Bird Fancier’s Lung—Comment on: Kumar R., Singh M. “Bird Fancier’s Lung: Clinical-Radiological Presentation in 15 Cases”

by Tadeusz M. Zielonka

Adv. Respir. Med. 2015, 83(3), 240-242; https://doi.org/10.5603/PiAP.2015.0039 - 30 Apr 2015

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Abstract

Recently, in Polish Pneumology and Allergology an interesting paper from India presenting 15 cases of pigeon fancier’s lung was published [...] Full article

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Open AccessLetter

Odpowiedź autorki na komentarz T.M. Zielonki “Czy pierścień naczyniowy był przyczyną duszności?”

by Magdalena Orwaldi

Adv. Respir. Med. 2015, 83(3), 238-239; https://doi.org/10.5603/PiAP.2015.0038 - 30 Apr 2015

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Abstract

Dziękuję za komentarz i wnikliwą analizę przedstawionego przypadku [...] Full article

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Open AccessReview

Tiotropium and Its Efficacy in the Treatment of COPD

by Maciej Kupczyk, Paweł Szepiel and Piotr Kuna

Adv. Respir. Med. 2015, 83(3), 229-237; https://doi.org/10.5603/PiAP.2015.0037 - 30 Apr 2015

Cited by 1 | Viewed by 310

Abstract

Exacerbations of chronic obstructive pulmonary disease (COPD) have a negative effect on the clinical course and outcome of the disease thus causing considerable social and economic burden. As the natural course of the disease may vary, the treatment should take into account an [...] Read more.

Exacerbations of chronic obstructive pulmonary disease (COPD) have a negative effect on the clinical course and outcome of the disease thus causing considerable social and economic burden. As the natural course of the disease may vary, the treatment should take into account an individual approach to a patient. The appropriate treatment makes it possible to control the symptoms, improves effort tolerance and decreases the risk of exacerbations and death. Tiotropium is a muscarinic receptor antagonist, which is taken once daily, in maintenance therapy, in every stage of the disease progress. The efficacy of tiotropium in regards to exacerbations of chronic obstructive pulmonary disease has been evaluated in many clinical trials against placebo and several different active comparators. This review presents the results of those studies with the main goal to evaluate the efficacy of treatment with tiotropium in terms of prevention and course of exacerbations. Full article

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Open AccessReview

The Role of Questionnaires in the Assessment of Asthma Control

by Marek Przybyszowski and Grażyna Bochenek

Adv. Respir. Med. 2015, 83(3), 220-228; https://doi.org/10.5603/PiAP.2015.0036 - 30 Apr 2015

Cited by 2 | Viewed by 326

Abstract

The achievement and the maintenance of asthma control is currently considered the main goal of asthma treatment. Recent guidelines recommend regular assessment of asthma control and indicate questionnaires as important tools that can facilitate its evaluation. Questionnaires relate to GINA or NAEPP guidelines. [...] Read more.

The achievement and the maintenance of asthma control is currently considered the main goal of asthma treatment. Recent guidelines recommend regular assessment of asthma control and indicate questionnaires as important tools that can facilitate its evaluation. Questionnaires relate to GINA or NAEPP guidelines. Questionnaires constitute complex numerical or categorical scales and consist of several to over a dozen questions relating to the patient’s symptoms of asthma, limitations in daily activities and usage of rescue medications within a period of time. Each questionnaire is characterized by the features that affect its reliability and usefulness. In the following paper we discuss most of the questionnaires which assess asthma control. We focus on the items they include and present the results of studies that prove the effectiveness of individual questionnaires in assessment of asthma control. Attention was drawn to the patient groups to which the questionnaires are addressed. We list the features of the questionnaire which should be considered before choosing a test, so that it satisfies both the doctor’s and the patient’s needs. The role of questionnaires as the easy-to-use tools is growing steadily. Unfortunately, not all are available in Polish language. Conducting appropriate validation studies may allow to use many of them in Polish conditions. Full article

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Open AccessCase Report

Acute Laryngeal Dyspnea as First Presentation of Granulomatosis with Polyangiitis

by Anna Maria Pajor, Sylwia Kwiatkowska, Jadwiga Kroczyńska-Bednarek and Wojciech J. Piotrowski

Adv. Respir. Med. 2015, 83(3), 216-219; https://doi.org/10.5603/PiAP.2015.0035 - 30 Apr 2015

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Abstract

Granulomatosis with polyangiitis (GPA) is a multi-organ disease which mostly affects lungs, kidney, and head and neck region. We report a rare case of acute laryngeal dyspnea and rapidly progressive pulmonary changes as first manifestations of disease. A 53 year-old woman presented with [...] Read more.

Granulomatosis with polyangiitis (GPA) is a multi-organ disease which mostly affects lungs, kidney, and head and neck region. We report a rare case of acute laryngeal dyspnea and rapidly progressive pulmonary changes as first manifestations of disease. A 53 year-old woman presented with symptoms of two-week dyspnea, which aggravated rapidly in the preceding hours. Laryngological examination revealed subglottic infiltrations and vocal fold oedema which required urgent tracheotomy. During few days she developed gingival ulcerations and pulmonary infiltration with negative serum c-ANCA titers. The histopathological examination of subglottic and gingival biopsies and the clinical picture established the diagnosis of GPA. She was treated with prednisone and cyclophosphamide with recovery; however, during over 3 years of follow-up, pulmonary symptoms relapsed and subglottic stenosis persisted. The difficulties in diagnosis and treatment in this unusual presentation of GPA are outlined with conclusion that in patients with subglottic infiltration, which develops rapidly, even when this is a sole presentation of the disease, and when c-ANCA are negative, GPA should always be considered. Full article

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Open AccessCase Report

Synchronous Two Distinct Neuroendocrine Lung Cancer Lesions

by Mateusz Rydel, Damian Czyżewski, Katarzyna Stęplewska, Agnieszka Zygo and Mariusz Adamek

Adv. Respir. Med. 2015, 83(3), 212-215; https://doi.org/10.5603/PiAP.2015.0034 - 30 Apr 2015

Cited by 1 | Viewed by 263

Abstract

The synchronous primary lung tumors is a rare condition and presented patient is the first reported case of simultaneous two distinct neuroendocrine lung cancer lesions in the same lobe. We present the case of a 55-year-old woman with synchronous two distinct neuroendocrine lung [...] Read more.

The synchronous primary lung tumors is a rare condition and presented patient is the first reported case of simultaneous two distinct neuroendocrine lung cancer lesions in the same lobe. We present the case of a 55-year-old woman with synchronous two distinct neuroendocrine lung cancer lesions in the right upper lobe. Initially she showed no signs or symptoms related to lung lesions and was admitted to Thoracic Surgery Ward for the investigation of two oval, solitary pulmonary nodules (11 and 19 mm in diameter) detected on a chest X-ray performed three months earlier. The radiological imaging showed a variability of growth of both lesions (smaller tumor has enlarged while the larger one remained unchanged). After the CT-guided lung biopsy, patient underwent right upper lobectomy. Histological examination revealed a small cell carcinoma in one of the tumors and a large cell neuroendocrine carcinoma in the other one. The patient was discharged in good condition and lung inflation in chest X-ray and qualified for adjuvant chemotherapy with a combination of cisplatin and etoposide and the prophylactic cranial irradiation. Very important issues, having impact on outcome of patients with multiple lung tumours is differentiation whether the lesions are metastases or synchronous primary lung tumors and the optimal management of these patients. Full article

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Open AccessCase Report

Bronchioloalveolar Cell Carcinoma Presenting as a “Non-Resolving Consolidation” for Two Years

by Elias Mir, Richa Sareen, Ritu Kulshreshtha and Ashok Shah

Adv. Respir. Med. 2015, 83(3), 208-211; https://doi.org/10.5603/PiAP.2015.0033 - 30 Apr 2015

Cited by 1 | Viewed by 272

Abstract

Bronchioloalveolar carcinoma (BAC), a rare form of lung malignancy, is usually seen in non-smokers and women. Three distinct histological forms have been identified viz, mucinous, non-mucinous and mixed or indeterminate. The mucinous variety of BAC may present as a consolidation which is very [...] Read more.

Bronchioloalveolar carcinoma (BAC), a rare form of lung malignancy, is usually seen in non-smokers and women. Three distinct histological forms have been identified viz, mucinous, non-mucinous and mixed or indeterminate. The mucinous variety of BAC may present as a consolidation which is very difficult to differentiate from an infective pneumonia. We present a case of a middle aged female who was evaluated for a “non-resolving consolidation” for a period of two years. She had undergone an inconclusive bronchoscopy and had received several courses of antibiotics including anti-tuberculous therapy without relief. The size of the lesion had remained largely unchanged during this period and there was no significant clinical deterioration in the patient. Transbronchial biopsy done on presentation revealed BAC of the mucinous variety. BAC presenting as a large consolidation without significant change for a period of two years has rarely been documented in the literature. Full article

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Open AccessArticle

High-Mobility Group Box 1 Protein Levels in Serum of Subjects after Exposure to Fire Smoke—Short Communication

by Anna Krakowiak, Konrad Śliwkiewicz, Ewa Nowakowska-Swirta, Renata Winnicka and Piotr Politański

Adv. Respir. Med. 2015, 83(3), 203-207; https://doi.org/10.5603/PiAP.2015.0032 - 30 Apr 2015

Cited by 1 | Viewed by 286

Abstract

Introduction: Fire smoke inhalation a recognized etiologic factor of airway injuries. The objective of this study was evaluation of serum high-mobility group box 1 (HMGB1) protein concentration in subjects exposed to fire smoke (SEFS). Materials and Methods: The study group consisted of 40 [...] Read more.

Introduction: Fire smoke inhalation a recognized etiologic factor of airway injuries. The objective of this study was evaluation of serum high-mobility group box 1 (HMGB1) protein concentration in subjects exposed to fire smoke (SEFS). Materials and Methods: The study group consisted of 40 consecutive patients admitted to the Toxicology Unit, Lodz, Poland after exposure to fire smoke. Serum HMGB1 concentrations were measured upon admission to hospital and rechecked on the 2nd and on the day of discharge. Patients also underwent routine toxicological diagnostic procedures applied in case of those exposures, such as carboxyhaemoglobin (COHb) levels and urinary thiocyanate concentrations. The same diagnostic tests were performed in 10 healthy volunteers not exposed to smoke of the control group. Results: The average serum SEFS concentration of HMGB1 protein was not significantly higher on admission in comparison with the respective values recorded on the 2nd day and on the day of discharge. The mean serum level of HMGB1 protein of exposed group was higher than that one in the control group, however the difference was not statistically significant. The highest concentration of HMGB1 protein was noted in serum of 28 subjects exposed to fire smoke reporting at least one symptom and the difference was statistically significant in a comparison with the control group. Conclusions: As indicated, an acute exposure to smoke may lead to transient increase of HMGB1 in serum in exposed subjects. Further studies are necessary in order to confirm the importance of this protein in pathogenesis of acute airway injury due to exposure to fire smoke. Full article

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Open AccessArticle

Causes of Deaths in COPD Patients in Primary Care Setting—A 6-Year Follow-Up

by Robert Pływaczewski, Janusz Maciejewski, Michał Bednarek, Jan Zieliński, Dorota Górecka and Paweł Śliwiński

Adv. Respir. Med. 2015, 83(3), 193-202; https://doi.org/10.5603/PiAP.2015.0031 - 30 Apr 2015

Cited by 2 | Viewed by 427

Abstract

Introduction: COPD is one of the most frequent respiratory diseases responsible for patients’ disability and mortality. In 2005 a single primary care practice, COPD was diagnosed in 183 out of 1960 eligible subjects ≥ 40 years (9.3%). The aim of this study was [...] Read more.

Introduction: COPD is one of the most frequent respiratory diseases responsible for patients’ disability and mortality. In 2005 a single primary care practice, COPD was diagnosed in 183 out of 1960 eligible subjects ≥ 40 years (9.3%). The aim of this study was to assess mortality rate and causes of deaths in this group after 6 years. Materials and Methods: In 2011 we invited all 183 patients with COPD recognised in 2005. We performed spirometry, physical examination, questionnaire of respiratory symptoms, smoking habits, concomitant diseases and treatment. Information about deaths was taken from primary care register, furthermore, family members were asked to deliver medical documentation or death certificate. Results: In 2011 we studied only 74 subjects (40.4%), 43 subjects died (23.5%) and 66 subjects were lost from the follow-up (36.1%). Cardiovascular diseases were the most frequent causes of deaths—21 subjects (48.8%) (heart attack–8 patients and stroke–8 patients). Respiratory failure in the course of COPD exacerbation was the cause of 10 deaths (23.3%). Neoplastic diseases lead to 9 deaths (20.9%) (lung cancer 7 patients). Renal insufficiency was responsible for one death (2.325%), and the causes of 2 deaths remained unknown (4.65%). Subjects who died (predominantly males) were older, had higher MRC score and lower FEV_₁. Conclusions: Study performed six years after COPD diagnosis revealed that 23.5% of subjects died. The main causes of deaths were the following: cardiovascular diseases (mainly heart attack and stroke), COPD exacerbations and lung cancer (more than 75%). Death risk in COPD patients was associated with age, male sex, dyspnoea and severity of the disease. Full article

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Open AccessArticle

Anaphylaxis as a Cause of Hospitalization—A Single Academic Centre Experience

by Katarzyna Baran, Krzysztof Pałgan, Marcin Szortyka, Anna Bitner, Zbigniew Bartuzi and Jacek J. Klawe

Adv. Respir. Med. 2015, 83(3), 188-192; https://doi.org/10.5603/PiAP.2015.0030 - 30 Apr 2015

Viewed by 327

Abstract

Introduction: In recent years, more and more often the increase in incidence of allergies is observed. According to the WHO, they are getting the fourth position amongst the most frequent diseases after cancers, cardiovascular diseases and AIDS. Anaphylaxis is a severe, life-threatening, systemic [...] Read more.

Introduction: In recent years, more and more often the increase in incidence of allergies is observed. According to the WHO, they are getting the fourth position amongst the most frequent diseases after cancers, cardiovascular diseases and AIDS. Anaphylaxis is a severe, life-threatening, systemic or generalised immediate hypersensitivity reaction. The analysis of the causes and the clinical picture of anaphylaxis in patients treated at single academic hospital centre was the purpose of the study. Materials and Methods: The study was based on retrospective analysis of case records of the patients hospitalised at the Chair and Department of Allergology, Clinical Immunology and Internal Diseases, the Jan Biziel University Hospital in Bydgoszcz in the years 2005−2010. 132 patients, in whom anaphylactic reaction appeared, were analysed. The examined population included 70 men and 62 women at 16−95 years of age. Results: The conducted examinations allowed to obtain information about the causes and the course of anaphylactic reactions. The problem of hypersensitivity to substances of various origin (biological or synthetic) can concern everyone irrespective of sex and age. Nevertheless, the phenomenon of anaphylaxis more often occurred in the examined men than women. Most cases of anaphylactic reactions were reported in the 26−50 age range. Based on the presented results, no regularity was observed in anaphylaxis clinical picture and its causative factor. Conclusions: It is difficult to forecast the course of the reaction based on the causative factor, for anaphylactic reaction is characterised by a great individual changeability and intensity of the first symptoms. Full article

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Open AccessArticle

Epidemiology of Asthma in Poland in Urban and Rural Areas, Based on Provided Health Care Services

by Andrzej Śliwczyński, Melania Brzozowska, Petre Iltchew, Tomasz Czeleko, Aleksandra Kucharczyk, Tadeusz Jędrzejczyk, Karina Jahnz-Różyk and Michał Marczak

Adv. Respir. Med. 2015, 83(3), 178-187; https://doi.org/10.5603/PiAP.2015.0029 - 30 Apr 2015

Cited by 2 | Viewed by 492

Abstract

Introduction: Asthma is a serious health and social problem, also in Poland. The epidemiological data indicate that the problem of asthma concerns approximately 4 million people in Poland, whereas almost approximately 70% of them have no diagnosis and are not aware of their [...] Read more.

Introduction: Asthma is a serious health and social problem, also in Poland. The epidemiological data indicate that the problem of asthma concerns approximately 4 million people in Poland, whereas almost approximately 70% of them have no diagnosis and are not aware of their illness, and on the other hand in 39% of persons who declared the diagnosis of asthma in a survey the diagnosis was negatively verified (overdiagnosis of asthma). So far, no detailed comparative studies for asthma incidence rate in urban and rural areas were conducted in Poland. The aim of the study was to analyze patients with asthma in Poland in the years 2008−2012, with regard to province and type of commune (rural/urban). Material and Methods: The study used data from National Health Fund (NFZ) — reported by health care providers regarding the patients diagnosed with asthma. Using structured query language (SQL) a set of patients was selected and created, for whom at the same time ICD-10 code: J45.X-bronchial asthma was reported. In order to estimate the number of patients with asthma we used the PESEL social security number as a unique identifier of the patient. Code of the patient’s commune of residence in conjunction with the Central Statistical Office data formed the basis for the division of municipalities into urban and rural areas. The analysis of asthma incidence trends in Poland was performed on the basis of health services provided to patients. The analysis was performed by using the Statistica 10 software using a negative binomial regression model. Results: In 2009 a significant increase in the number of patients with asthma was observed compared with the previous year, whereas after 2009 the number of patients diagnosed with asthma remained relatively constant. A significant increase of predominance of women among asthma patients in recent years can be noticed: from 107% in 2008 to almost 115% in 2012 (F:M ratio). Regardless of the analyzed year and the diagnosis the incidence rate remained constant: approximately 55−57% for urban areas and about 43−45% in rural areas. Conclusions: The average prevalence rate for rural areas is significantly lower than for urban areas. The use of adjusted incidence rate leads to the conclusion that the number of sufferers in urban areas is higher (about 10%) of the number of sufferers in the rural areas. The results of the analysis are consistent with information from previous studies in Poland and in the world. Full article

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Open AccessEditorial

Anaphylaxis

by Jerzy Kruszewski

Adv. Respir. Med. 2015, 83(3), 175-177; https://doi.org/10.5603/PiAP.2015.0028 - 30 Apr 2015

Viewed by 266

Abstract

Anaphylaxis is recently becoming an increasingly popular issue among allergists, particularly upon fatigue with asthma matters. The paper “Anaphylaxis as a cause of hospitalization—a single academic centre experience” published in this issue of “Polish Pneumonology and Allergology” follows this trend [...] Full article

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Adv. Respir. Med., Volume 83, Issue 3 (April 2015) – 14 articles , Pages 175-246

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