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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 83, Issue 4 (July 2015) – 13 articles , Pages 247-340

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222 KiB  
Case Report
Organizing Pneumonia Appearing in B-Cell Chronic Leukemia Malignancy Progression—A Case Report
by Mateusz Marek Polaczek, Jacek Zych, Lucyna Opoka, Beata Maksymiuk and Kazimierz Roszkowski-Sliż
Adv. Respir. Med. 2015, 83(4), 307-311; https://doi.org/10.5603/PiAP.a2015.0042 - 20 Jul 2015
Cited by 1 | Viewed by 501
Abstract
Patients with chronic lymphocytic leukemia or non-Hodgkin’s lymphoma are at risk of infectious diseases of respiratory system because of immunodeficiency. Occurrence of organizing pneumonia in leukemic patients is most commonly correlated with bone marrow transplant or treatment with antimitotic agents. There have been [...] Read more.
Patients with chronic lymphocytic leukemia or non-Hodgkin’s lymphoma are at risk of infectious diseases of respiratory system because of immunodeficiency. Occurrence of organizing pneumonia in leukemic patients is most commonly correlated with bone marrow transplant or treatment with antimitotic agents. There have been only four reported cases of organizing pneumonia related solitarily to leukemia or lymphoma. We present a case of 65-year old gentlemen, diagnosed 8 months earlier with B-cell chronic lymphocytic leukemia with no previous hematologic treatment, who presented symptoms of persistent pneumonia with no significant reaction to antibiotics. Chest computed tomography scans showed well-localized consolidation with ground glass opacities and some air bronchogram, suggesting infectious disease. All results of microbiological examinations were negative. Due to radiological progression of parenchymal consolidation despite two intravenous courses of antibiotics open lung biopsy was performed. The histologic examination of lung specimen revealed structures typical for organizing pneumonia pattern. There was no evidence for leukemic involvement in lung tissue, as no sign for infectious factors from histological staining was observed. In the inferior mediastinal lymph node sample progression of chronic lymphatic leukemia to mixed cell lymphoma was diagnosed. Patient was commenced on prednisone 60 mg/daily with fast improvement. We believe that this is the first case of organizing pneumonia as a reaction to the conversion of B-cell chronic lymphocytic leukemia progression to more malignant stage. Full article
104 KiB  
Letter
First Polish Conference on Sarcoidosis
by Joanna Domagała-Kulawik and Anna Dubaniewicz
Adv. Respir. Med. 2015, 83(4), 339-340; https://doi.org/10.5603/PiAP.2015.0054 - 9 Jul 2015
Viewed by 301
Abstract
“Sarcoidosis has many names” (“Sarkoidoza niejedno ma imię”) the First Polish Conference on Sarocidosis, Ciechocinek, 25 April 2015 has documented this original term [...] Full article
152 KiB  
Review
The Statement of the Polish Society of Allergology Regarding Necessary Changes in Therapeutic Program of Severe IgE-Mediated Allergic Asthma with Omalizumab
by Zbigniew Bartuzi, Anna Bodzenta-Łukaszyk, Piotr Kuna, Izabela Kupryś -Lipińska, Ewa Niżankowska -Mogilnicka and Bolesław Samoliński
Adv. Respir. Med. 2015, 83(4), 335-338; https://doi.org/10.5603/PiAP.2015.0053 - 9 Jul 2015
Cited by 3 | Viewed by 385
Abstract
According to the current (2015) recommenda-tions of Global Initiative for Asthma (GINA) dealing under the auspice of World Health Organization (WHO) and in line with registered by EMA in EU as well as in Poland Summary of Product Charac-teristics (SmPC) [...] [...] Read more.
According to the current (2015) recommenda-tions of Global Initiative for Asthma (GINA) dealing under the auspice of World Health Organization (WHO) and in line with registered by EMA in EU as well as in Poland Summary of Product Charac-teristics (SmPC) [...] Full article
295 KiB  
Review
The Statement of the Polish Society of Allergology Experts on the Treatment of Difficult-To-Treat Asthma
by Anna Bodzenta-Łukaszyk, Andrzej M. Fal, Ewa Jassem, Marek L. Kowalski, Piotr Kuna and Maciej Kupczyk
Adv. Respir. Med. 2015, 83(4), 324-334; https://doi.org/10.5603/PiAP.2015.0052 - 9 Jul 2015
Cited by 3 | Viewed by 397
Abstract
The main objective of asthma treatment is to control symptoms of the disease; however, despite the availability of guidelines and many groups of medications, the degree of control of this condition is insufficient. In difficult-to-treat asthma, the optimal control cannot be achieved due [...] Read more.
The main objective of asthma treatment is to control symptoms of the disease; however, despite the availability of guidelines and many groups of medications, the degree of control of this condition is insufficient. In difficult-to-treat asthma, the optimal control cannot be achieved due to reasons independent of the disease. Factors worsening asthma control include: inadequate treatment plan (low therapy adherence and compliance), inappropriate inhalation technique, insufficient symptom control using the available classes of medications, incomplete response to treatment (non-responders, steroid-resistance), incorrect diagnosis of asthma or comorbidities, and environmental factors. In order to achieve the optimal asthma control, it is recommended to: take therapeutic decisions with the patient, assess the probability of non-compliance, perform detailed diagnostics and initiate treatment of concomitant diseases, carry out differential diagnosis of conditions mimicking asthma, educate the patient as to the inhalation technique and check it, eliminate unfavourable environmental factors, and modify current treatment. New treatment options for patients with asthma include: ultra-long-acting beta2-agonists, long-acting muscarine receptor antagonists (LAMA), monoclonal antibodies, and non-pharmacological interventions. The only LAMA approved for treatment of asthma is tiotropium bromide. The analyses performed demonstrated a high efficacy of tiotropium in terms of improved lung function parameters and prolonged time to the first asthma exacerbation. It is recommended as an add-on therapy at asthma treatment steps 4 and 5 according to GINA (Global Initiative for Asthma) 2014. The optimal asthma control is important from the medical as well as the economical point of view. Full article
470 KiB  
Review
Pulmonary Hypertension in the Course of Diffuse Parenchymal Lung Diseases—State of Art and Future Considerations
by Monika Szturmowicz, Aneta Kacprzak, Katarzyna Błasińska-Przerwa and Jan Kuś
Adv. Respir. Med. 2015, 83(4), 312-323; https://doi.org/10.5603/PiAP.2015.0051 - 9 Jul 2015
Cited by 2 | Viewed by 402
Abstract
Lung diseases are one of the most frequent causes of pulmonary hypertension (PH). The development of PH influences the course of lung disease, worsening the clinical symptoms and prognosis. According to the most recent publications, PH in the course of lung diseases develops [...] Read more.
Lung diseases are one of the most frequent causes of pulmonary hypertension (PH). The development of PH influences the course of lung disease, worsening the clinical symptoms and prognosis. According to the most recent publications, PH in the course of lung diseases develops as a result of both “parenchymal” and vascular pathology, in the patients with genetic predisposition. Prolonged infection (especially viral one) may be an additional promoting factor. Right heart catheterization (RHC), which is an invasive procedure, is the only objective method of diagnosing PH. According to the latest recommendations, the management algorithm of PH and coexisting interstitial lung disease is based on RHC and the results of pulmonary function tests. Majority of the patients develop mild PH in the course of advanced lung disease. Best treatment of underlying lung pathology combined with long term oxygen treatment is recommended in this group. In case of severe PH (mean resting pulmonary artery pressure (mPAP) ≥ 35 mm Hg) the alternate cause of PH has to be sought. PAH-specific drugs use should be limited to patients with severe PH participating in clinical trials. In this review, the value of various non-invasive methods (echocardiography, radiological examination, exercise capacity and brain natriuretic peptides assessment) in the process of screening for PH is presented, and the results of recent randomized clinical trials with PAH-specific drugs in patients with diffuse parenchymal lung diseases are discussed. Full article
224 KiB  
Case Report
Self-Expandable Metallic Stents in Oesophago-Respiratory Fistulas Treatment in Neoplasms—Case Reports and Literature Review
by Witold Marczyński, Marek Pająk, Teresa Komandowska and Izabella Nikiel
Adv. Respir. Med. 2015, 83(4), 303-306; https://doi.org/10.5603/PiAP.2015.0050 - 9 Jul 2015
Cited by 3 | Viewed by 354
Abstract
Self-expandable metallic stents (SEMS) insertion to the oesophagus is the method of choice in palliative treatment of malignant oesophago-respiratory fistulas (ERF). ERF evolve as a result of 0.2−5% of advanced oesopghageal or lung cancer. They also appear after radiotherapy. EFR are serious and [...] Read more.
Self-expandable metallic stents (SEMS) insertion to the oesophagus is the method of choice in palliative treatment of malignant oesophago-respiratory fistulas (ERF). ERF evolve as a result of 0.2−5% of advanced oesopghageal or lung cancer. They also appear after radiotherapy. EFR are serious and lethal complications. SEMS insertion is an effective, safe, technically simple and minimally invasive solution. Potential complications of SEMS include thoracic pain, bleeding, perforation, stent migration, tumour overgrowth or ingrowth and food bolus impaction. The article presents three cases of patients with advanced lung cancer with EFR subjected to SEMS insertion procedure in our centre. Full article
207 KiB  
Case Report
Squamous Cell Lung Cancer in a Male with Pulmonary Tuberculosis
by Marcin Skowroński, Katarzyna Iwanik, Anna Halicka and Aleksander Barinow-Wojewódzki
Adv. Respir. Med. 2015, 83(4), 298-302; https://doi.org/10.5603/PiAP.2015.0049 - 9 Jul 2015
Cited by 4 | Viewed by 434
Abstract
Lung cancer and pulmonary tuberculosis (TB) are highly prevalent and representing major public health issues. They share common risk factors and clinical manifestations. It is also suggested that TB predicts raised lung cancer risk likely related to chronic inflammation in the lungs. However, [...] Read more.
Lung cancer and pulmonary tuberculosis (TB) are highly prevalent and representing major public health issues. They share common risk factors and clinical manifestations. It is also suggested that TB predicts raised lung cancer risk likely related to chronic inflammation in the lungs. However, it does not seem to influence the clinical course of lung cancer provided that it is properly treated. We present a case report of a 57-year old male with concurrent TB and lung cancer. He was diagnosed with positive sputum smear for acid fast bacilli (AFB) and subsequent culture of Mycobacterium tuberculosis. Besides, his comorbid conditions were chronic hepatitis C virus (HCV) infection and peripheral artery disease (PAD). Later while on anti-tuberculous treatment (ATT) squamous cell lung cancer (SCC) was confirmed with computed tomography (CT) guided biopsy. Due to poor general condition the patient was not fit for either surgery or radical chemo- and radiotherapy. He was transferred to hospice for palliative therapy. We want to emphasize that both TB and lung cancer should be actively sought for in patients with either disorder. In addition, there is no doubt that these patients with lung cancer and with good response to TB treatment should be promptly considered for appropriate anticancer therapy. Full article
296 KiB  
Guidelines
Polish Respiratory Society Guidelines for the Methodology and Interpretation of the 6 Minute Walk Test (6MWT)
by Tadeusz Przybyłowski, Waldemar Tomalak, Zenon Siergiejko, Dariusz Jastrzębski, Marta Maskey-Warzęchowska, Tomasz Piorunek, Emil Wojda and Piotr Boros
Adv. Respir. Med. 2015, 83(4), 283-297; https://doi.org/10.5603/PiAP.2015.0048 - 9 Jul 2015
Cited by 18 | Viewed by 524
Abstract
Podstawowym celem tego dokumentu jest opracowanie spójnych wytycznych dotyczących wskazań, przeciwwskazań, metodyki i zasad interpretacji testu 6-minutowego chodu (6MWT, 6 min walk test) w ramach codziennej praktyki szpitalnej i ambulatoryjnej [...] Full article
319 KiB  
Article
Indoor Air Pollution and Asthma in Children at Delhi, India
by Raj Kumar, Jitendra K. Nagar, Nitin Goel, Pawan Kumar, Alka S. Kushwah and Shailendra N. Gaur
Adv. Respir. Med. 2015, 83(4), 275-282; https://doi.org/10.5603/PiAP.2015.0047 - 9 Jul 2015
Cited by 18 | Viewed by 814
Abstract
Introduction: Several studies in developed countries have shown association between indoor air pollution and asthma in children. The present research was undertaken to study this association at Delhi, India. Materials and Methods: This study took place at Delhi, capital of India. [...] Read more.
Introduction: Several studies in developed countries have shown association between indoor air pollution and asthma in children. The present research was undertaken to study this association at Delhi, India. Materials and Methods: This study took place at Delhi, capital of India. Eight locations based on the source of pollution such as industrial, residential and villages were included. Recording of the demographic profile and clinical examination of each child was conducted at their residence. Indoor SO₂, NO₂ and SPM (suspended particulate matter) levels were measured by using Handy Air Sampler (Low Volume Sampler). Results: A total of 3104 children were examined of which 60.3% were male and 39.7% were female. 32.4% children were exposed to environmental tobacco smoke. 31.5% children’s families were using biomass fuels for cooking. History of respiratory symptoms included cough (43.9%), phlegm production (21.9%), shortness of breath (19.3%) and wheezing (14.0%). 7.9% children were diagnosed as having asthma, which was highest in industrial areas (11.8%), followed by residential (7.5%) and village areas (3.9%). The mean indoor SO₂, NO₂ and SPM levels were 4.28 ± 4.61 mg/m³, 26.70 ± 17.72 mg/m³ and 722.0 ± 457.6 mg/m³ respectively. Indoor SPM was the highest in industrial area followed by residential area and urban village area. Indoor SPM level was significantly (p < 0.001) higher in the asthmatic children’s houses. Conclusion: This study suggests that industry plays an important role in increasing the concentration of indoor suspended particulate matter and occurrence of asthma in children in developing countries like India. Full article
221 KiB  
Article
Quality of Life and Health Behaviours of Patients with Tuberculosis—Sex Differences
by Beata Katarzyna Jankowska-Polanska, Małgorzata Kamińska, Izabella Uchmanowicz and Anna Rycombel
Adv. Respir. Med. 2015, 83(4), 256-265; https://doi.org/10.5603/PiAP.2015.0046 - 9 Jul 2015
Cited by 4 | Viewed by 601
Abstract
Introduction: Despite the Introduction of effective antituberculosis drugs, tuberculosis (TB) is still a serious health problem and one of the most significant causes of death among infectious diseases. Current publications indicate an increase of tuberculosis cases among smokers, diabetics, malnurished subjects and those [...] Read more.
Introduction: Despite the Introduction of effective antituberculosis drugs, tuberculosis (TB) is still a serious health problem and one of the most significant causes of death among infectious diseases. Current publications indicate an increase of tuberculosis cases among smokers, diabetics, malnurished subjects and those abusing alcohol and drugs. In the literature, there are only few studies raising the topic of the quality of life (QoL), stress management and health behaviour among patients with tuberculosis. The aim of this study was to evaluate QoL of patients with tuberculosis taking into account gender differences. In the study, the analysis of knowledge, health behaviour and stress management among TB patients depending on sex was carried out. Materials and Methods: The study included 80 subjects diagnosed with TB (including 38 females) who were hospitalised at the Regional Hospital Centre of Kotlina Jeleniogórska, Medical Unit Wysoka Łąka, Pulmonology and Phthisiology Department in Kowary between August 2012 and January 2013. The following questionnaires were used in the study: Mini-COPE—evaluating stress management, WHOQoL—assessing the quality of life of patients, IZZ—assessing health behaviour. Results: A difference with regards to sociodemographic profile between females and males was observed. Half of the women surveyed were working (50% vs. 19% of men), whereas half of men were entitled to unemployment benefit (50% vs. 18.4% of women). More than half of women lived with their family (55.3%), whereas 47.6% of men lived alone. The majority of the subjects consumed alcohol occasionally (60.2% of women vs. 45.2% of men), but as many as 31% of male patients vs 7.9% of females admitted that they consumed alcohol frequently. Among the respondents, people who consumed alcohol occasionally dominated (60.2% women vs. 45.2% of men), but as many as 31% of male patients vs. 7.9% of women admitted to consume alcohol frequently. Quality of life (QoL) assessment has shown no statistically significant differences between the sexes in this field. The respondents rated lowest their QoL in the physical domain, 12.4 ± 3.1 (12.9 ± 3.0 women vs. 11.8 ± 3.1 men) and 12.6 ± 2.4 in the environmental domain (13.1 ± 2.3 women vs. 12.1 ± 2.4 men). Women received a higher rating of health behaviour on all subscales of the IZZ questionnaire, with the highest score in the prevention behaviour subscale (3.6 ± 0.7) and the lowest in the subscale of proper eating habits (3.1 ± 0.8). In men the highest score of health behaviour was observed in the subscale of positive mental attitude (3.1 ± 1.0) and the lowest in the subscale of proper eating habits (2.5 ± 0.8). Conclusions: 1. There are differences between sociodemographic profile of TB patients: women are younger, better educated, economically active and more likely to remain in relationships; 2. There is no difference in QoL of TB patients between the sexes, whereas there are differences in the strategies of stress management and in applied health behavior; 3. Differences between genders indicate the need for matching treatment and preventive action for different patients profiles based on the cooperation of doctors, social workers, therapists, and psychologists. Full article
126 KiB  
Editorial
Air Pollution and Childhood Asthma
by Cezary Pałczyński and Piotr Kuna
Adv. Respir. Med. 2015, 83(4), 247-249; https://doi.org/10.5603/PiAP.2015.0045 - 9 Jul 2015
Viewed by 344
Abstract
The prevalence of childhood asthma and allergies has dramatically increased worldwide during the last decades [...] Full article
240 KiB  
Article
Association between Asthma Control Test, Pulmonary Function Tests and Non-Specific Bronchial Hyperresponsiveness in Assessing the Level of Asthma Control
by Iwona Florentyna Grzelewska-Rzymowska, Joanna Mikołajczyk, Jadwiga Kroczyńska-Bednarek and Paweł Górski
Adv. Respir. Med. 2015, 83(4), 266-274; https://doi.org/10.5603/PiAP.a2015.0044 - 19 May 2015
Cited by 1 | Viewed by 485
Abstract
Introduction: Global Initiative for Asthma (GINA) reports emphasize the use of validated and simple tools in order to assess the level of asthma control, as the Asthma Control Test (ACT). However, an ACT does not include assessment of airway inflammation, which is [...] Read more.
Introduction: Global Initiative for Asthma (GINA) reports emphasize the use of validated and simple tools in order to assess the level of asthma control, as the Asthma Control Test (ACT). However, an ACT does not include assessment of airway inflammation, which is better reflected when measuring nonspecific bronchial hyperresponsiveness (BHR). The authors aimed to find out if the level of asthma control quantified by an ACT correlates with BHR and pulmonary function tests. Materials and Methods: 118 asthmatics participated in the study. All patients completed an ACT. The scores of the ACTs were compared with pulmonary function tests and BHR assessed with the methacholine challenge test and expressed as a provocative concentration of methacholine, inducing a 20% decline in the FEV1 (PC20M in mg/ml). Results: Patients with controlled asthma amounted to 52 (44%) while those with uncontrolled asthma amounted to 66 (56%). In patients with controlled asthma (ACT score ≥ 20) the mean geometric value of PC20M was 2.72 mg/ml (range from 0.25 to > 8.0), whereas 0.94 mg/ml (range from 0.28 to 8.0) (p = 0.02) was observed in patients with uncontrolled asthma (ACT score < 20). Almost 64% (21/33) of uncontrolled asthmatics achieved normal lung function (FEV1 > 80% pred. value) while 19% (5/26) patients with controlled asthma presented an FEV1 < 80% predicted value. Asthma duration in years in controlled asthmatics was significantly shorter than in uncontrolled patients (6.2 ± 8.9 vs. 12.0 ± 11.4, p = 0.005). Conclusion: In determining the most accurate level of asthma control it is reasonable to use an ACT in conjunction with BHR, which provides more accurate assessment of bronchial inflammation than ventilatory parameters alone. Full article
320 KiB  
Article
Pulmonary Presentation of Toxocara sp. Infection in Children
by Katarzyna Mazur-Melewska, Katarzyna Jonczyk-Potoczna, Paweł Kemnitz, Anna Mania, Magdalena Figlerowicz and Wojciech Służewski
Adv. Respir. Med. 2015, 83(4), 250-255; https://doi.org/10.5603/PiAP.a2015.0043 - 19 May 2015
Cited by 11 | Viewed by 517
Abstract
Introduction: The aim of this study was to investigate the associations between radiological findings, blood eosinophilia, hyperimmunoglobulinemia E and G and Toxocara seropositivity in Polish children with newly diagnosed pulmonary infiltration. Materials and Methods: We retrospectively analyzed the documentation of 119 patients, aged [...] Read more.
Introduction: The aim of this study was to investigate the associations between radiological findings, blood eosinophilia, hyperimmunoglobulinemia E and G and Toxocara seropositivity in Polish children with newly diagnosed pulmonary infiltration. Materials and Methods: We retrospectively analyzed the documentation of 119 patients, aged 1 to 18 years (mean age: 7.21 ± 4.82), who were seropositive in Toxocara sp. antibodies. In all cases, peripheral blood eosinophils and leukocyte counts, serum total IgE, IgG levels and specific IgG antibodies against excretory and secretory Toxocara sp. antigens were measured at the first presentation. After the confirmation of seropositivity, all children had a routine radiological examination. Results: In the documentation of 23 children (mean age 3.58 ± 2.63 years) we found abnormalities in the radiological examination of their lungs. Fifteen children who had abnormalities in radiological findings presented clinical respiratory complaints such as chronic cough, wheezing, asthma and haemoptysis. Eight children were asymptomatic. The analysis of peripheral eosinophils and leukocyte number, the level of IgE and specific anti-Toxocara IgG presented significantly higher values in children with radiological lesions than in children who had correct radiology. The concentrations of total IgG and gamma globulins were not significantly different. In 10 patients CT showed irregular round nodules with and without halo ranging from 1 to 13 mm. The number of nodules varied from a single lesion to multiple, disseminated ones. All nodules were located in peripheral areas of the lungs. None of them were found in the central areas. In 13 patients, CT images showed ground-glass opacities with ill-defined margins. None of the CT images presented lymphadenopathy and pleural effusion. Conclusions: The pulmonary lesions in small children with high eosinophilia and hyperimmunoglobulinemia E could be related to toxocariasis and for this reason they are eligible to undergo therapy with prolonged observation for several months, rather than start invasive malignancy investigations. Full article
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