Advances in Respiratory Medicine

179 KiB

Open AccessArticle

Typing Safe Antibiotics in Amoxicillin Hypersensitive Patients—Development of a Stepwise Protocol

by Krzysztof Specjalski, Karolina Kita-Milczarska, Marta Chełmińska and Ewa Jassem

Adv. Respir. Med. 2016, 84(1), 16-21; https://doi.org/10.5603/PiAP.2016.0001 - 19 Jan 2016

Cited by 3 | Viewed by 341

Introduction: A history of an adverse reaction to amoxicillin, irrespective of the mechanism involved, significantly elevates patients’ anxiety and affects therapeutic decisions in the future, leading to unnecessary avoidance of antibiotics. As a consequence, it would be useful to find a safe [...] Read more.

Introduction: A history of an adverse reaction to amoxicillin, irrespective of the mechanism involved, significantly elevates patients’ anxiety and affects therapeutic decisions in the future, leading to unnecessary avoidance of antibiotics. As a consequence, it would be useful to find a safe and reliable protocol for typing safe alternative antibiotics. The aim of the study was to determine negative predictive value of typing safe antibiotic in patients with a history of hypersensitivity reaction to amoxicillin. Material and methods: 71 patients, aged 20−83, with a history of an adverse reaction to amoxicillin were retrospectively analysed. On the basis of the reaction type they were divided into three groups: A—symptoms not typical for hypersensitivity reactions, B—allergy manifested by urticaria and/or angioedema, C—anaphylaxis. In group A amoxicillin was tested, in group B—cefuroxime, and in group C—macrolide: azithromycin or clarithromycin. Telephone follow-up visits were performed twice: 6−12 months and 3−5 years after the clinical assessment to evaluate tolerance of antibiotics. On the basis of the follow-up results, the negative predictive value (NPV) of the protocol was calculated. Results: The full diagnostic protocol was applied in 62 participants. Amoxicillin was found safe in 22, cefuroxime—in 21 and macrolide—in 19 patients. No anaphylactic reactions were observed during the tests. On the basis of the telephone follow-up, the NPV of the protocol was 96% in the first follow-up and 97% in the second one. Conclusion: A stepwise approach including SPTs, ICTs and provocations with amoxicillin / cefuroxime/macrolide—depending on a patient’s history—is safe and allows typing an antibiotic in the vast majority of patients. Full article

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Open AccessEditorial

European Spirometry Driving License in Poland—First Polish Spirometry Training in the Framework of ERS HERMES Spirometry Project

by Waldemar Tomalak, Monika Franczuk, Paweł Kuca and Małgorzata Czajkowska-Malinowska

Adv. Respir. Med. 2016, 84(1), 1-2; https://doi.org/10.5603/PiAP.2016.0002 - 19 Jan 2016

Viewed by 287

Abstract

HERMES Initiative (Harmonized Education of Respiratory Medicine in European Specialties) was born in the European Respiratory Society in 2005 [...] Full article

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Open AccessReview

Pulmonary Arterial Hypertension: A Current Review of Pharmacological Management

by Sonu Sahni, Marcin Ojrzanowski, Sebastian Majewski and Arunabh Talwar

Adv. Respir. Med. 2016, 84(1), 47-61; https://doi.org/10.5603/PiAP.a2015.0084 - 23 Dec 2015

Cited by 8 | Viewed by 511

Abstract

Pulmonary hypertension (PHTN) is a rare and devastating disease characterized by progressive increases in pulmonary arterial pressure and pulmonary vascular resistance, which eventually leads to right ventricular failure and death. At present there is no cure for pulmonary arterial hypertension (PAH); however over [...] Read more.

Pulmonary hypertension (PHTN) is a rare and devastating disease characterized by progressive increases in pulmonary arterial pressure and pulmonary vascular resistance, which eventually leads to right ventricular failure and death. At present there is no cure for pulmonary arterial hypertension (PAH); however over the past decade targeted pharmaceutical options have become available for the treatment of PAH. Prior to evaluation for therapeutic options a definitive diagnosis of pulmonary arterial hypertension must be made via comprehensive physical exam and definitive diagnostic testing. Screening test of choice remains echocardiography and gold standard for definitive diagnosis is right heart catheterization. Once the establishment of a diagnosis of PAH is made therapeutic options may be a possibility based on a diagnostic algorithm and disease severity of the PAH patient. There are different classes of medications available with different mechanisms of actions which net a vasodilatory effect and improve exercise tolerance, quality of life as well and survival. Full article

226 KiB

Open AccessReview

Usefulness of Lung Ultrasound in Diagnosing Causes of Exacerbation in Patients with Chronic Dyspnea

by Katarzyna Rogoza and Wojciech Kosiak

Adv. Respir. Med. 2016, 84(1), 38-46; https://doi.org/10.5603/PiAP.a2015.0083 - 21 Dec 2015

Cited by 4 | Viewed by 414

Abstract

Dyspnea is a non-specific symptom that requires fast diagnostics, accurate diagnosis and proper treatment. The most common causes of dyspnea include exacerbation of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). Distinction between these two medical conditions seems to be critical [...] Read more.

Dyspnea is a non-specific symptom that requires fast diagnostics, accurate diagnosis and proper treatment. The most common causes of dyspnea include exacerbation of chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF). Distinction between these two medical conditions seems to be critical in diagnostics of emergencies. At the same time, basic diagnostic tools available in emergency room, such as classic radiography (X-ray) of the chest, electrocardiography (ECG) or b-type natriuretic peptide test, are sometimes ambiguous. Therefore looking for additional diagnostic tool seems to be justified and necessary. Transthoracic lung ultrasound assessment is a simple and easily accessible examination, enabling the early and explicit diagnostics of pulmonary oedema and its distinction from other, non-cardiac causes of dyspnea. This review outlines the current knowledge on the subject of transthoracic lung ultrasound (TLUS), particularly in respect of its clinical usefulness in distinction of causes of dyspnea exacerbation. Full article

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Open AccessCase Report

Chronic Cough as a Symptom of Laryngopharyngeal Reflux—Two Case Reports

by Monika Kopka, Milena Małecka and Iwona Stelmach

Adv. Respir. Med. 2016, 84(1), 29-32; https://doi.org/10.5603/PiAP.a2015.0082 - 21 Dec 2015

Cited by 4 | Viewed by 336

Abstract

Laryngopharyngeal reflux (LPR) is a complex of symptoms caused by the backflow of gastric contents into the larynx, pharynx, nasopharynx, sinuses and even to the middle ear space.The symptomatology of LPR includes: chronic cough, hoarseness, throat clearing, laryngitis, “globus pharyngeus”, swallowing disturbances, postnasal [...] Read more.

Laryngopharyngeal reflux (LPR) is a complex of symptoms caused by the backflow of gastric contents into the larynx, pharynx, nasopharynx, sinuses and even to the middle ear space.The symptomatology of LPR includes: chronic cough, hoarseness, throat clearing, laryngitis, “globus pharyngeus”, swallowing disturbances, postnasal drip, “fetor ex ore”. In the article, the authors present two boys with chronic cough, in one of them the asthma was suspected and antiasthmatic treatment was administrated; in our patients according to the 24-hour pharyngeal pH-metry LPR was diagnosed. The aim of this study was to emphasise that pediatricians should be able to recognise symptoms of LPR. The appropriate diagnosis and treatment leads the symptoms to subside. Full article

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Open AccessArticle

Serum Levels of Apoptosis-Related Markers (sFasL, TNF-α, p53 and bcl-2) in COPD Patients

by Monika Kosacka, Irena Porębska, Anna Korzeniewska, Renata Rubinsztajn, Marcin Grabicki, Renata Jankowska, Halina Batura-Gabryel and Ryszarda Chazan

Adv. Respir. Med. 2016, 84(1), 11-15; https://doi.org/10.5603/PiAP.a2015.0080 - 21 Dec 2015

Cited by 10 | Viewed by 465

Abstract

Introduction: Taking into account important role of apoptosis in COPD pathogenesis, we wanted to asses the serum levels of markers involved in apoptosis regulation, including apoptosis inducers such as TNF-α, sFasL or p53 protein and apoptosis inhibitor bcl-2 and, in addition, to [...] Read more.

Introduction: Taking into account important role of apoptosis in COPD pathogenesis, we wanted to asses the serum levels of markers involved in apoptosis regulation, including apoptosis inducers such as TNF-α, sFasL or p53 protein and apoptosis inhibitor bcl-2 and, in addition, to compare these markers with selected COPD parameters. Material and methods: In 181 patients (60 women) with COPD (age was 62.2 + 9.37 years; FEV₁% 55.2 + 19.98 %) and in 29 controls (11 women), serum levels of TNF-α, sFasL, p53 and bcl-2 were evaluated by the enzyme-linked immunosorbent assay (ELISA) method. Results: In COPD patients the mean sFasL level was 0.092 ± 0.077 ng/mL and mean TNF-α level was 2.911 ± 3.239 pg/mL. There were no differences in serum sFasL and TNF-α in COPD patients and control group. TNF-α and sFasL did not correlate with COPD parameters such as FEV₁%, BMI, RV% (percentage of predicted value of residual volume) or BODE. Although we tried to evaluate bcl-2 and p53 protein serum levels with two different tests, measurable levels of bcl-2 were only detected in 15 patients and p53 in only 3 patients. Bcl-2 values were from 0.418 to 11.423 ng/mL and p53 from 90.772 to 994.749 pg/mL. Conclusions: We didn’t observe any differences in serum levels of pro- and antiapoptotic markers in COPD patients and the control group or correlations between the markers studied and COPD parameters. Full article

177 KiB

Open AccessArticle

Relation between Illness Acceptance and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease (COPD)

by Beata Jankowska-Polańska, Maria Kasprzyk, Anna Chudiak and Izabella Uchmanowicz

Adv. Respir. Med. 2016, 84(1), 3-10; https://doi.org/10.5603/PiAP.a2015.0079 - 21 Dec 2015

Cited by 15 | Viewed by 598

Abstract

Introduction: Despite the advances in medicine, COPD is still leading, incurable and chronic respiratory disease. It greatly restricts the functioning of patients in terms of physical, emotional and social aspects, reducing significantly their quality of life. The study into quality of life [...] Read more.

Introduction: Despite the advances in medicine, COPD is still leading, incurable and chronic respiratory disease. It greatly restricts the functioning of patients in terms of physical, emotional and social aspects, reducing significantly their quality of life. The study into quality of life in patients with COPD is becoming increasingly important as a valuable complement to the assessment of clinical status of the patient, the effects of therapy, effectiveness of educational programs, clinical evaluation of drugs, including the patient’s acceptance of the disease and treatment. Acceptance or lack thereof, can affect the healing process, result in the lack of cooperation and conscious participation of the patient in the therapeutic process, correlate negatively with different variables of treatment and may lead to the lack of cooperation between the patient and a therapeutic team. The aim of this study was to determine the correlation of acceptance of disease with quality of life in patients with chronic obstructive pulmonary disease. Material and methods: The study included 105 patients (including 29 women). Analysis was used to examine the medical records, the Acceptance of Illness Scale (AIS) and the World Health Organization Quality of Life-BREF (WHOQOL-Bref). Results: The results showed a significantly higher quality of life, in all domains of the questionnaire in patients with COPD who accept their illness to a high degree (AIS > 29). In the physical health domain, group I (lack of acceptance AIS 8−18) won 23.4 ± 13.7, group II (mean acceptance AIS 19−29) 47.9 ± 11.2, group III (high acceptance AIS > 29) 68.9 ± 12.8; p < 0.001. In the psychological domain, group I achieved 40.4 ± 9.2; group II 63.9 ± 9.7; group III 74.9 ± 10.1, in the social relationships domain, group I 48.4 ± 12.5; group II, 69.6 ± 12.7; group III 74.9 ± 10.1, in the environmental domain, group I 45.4 ± 10.7; group II, 62.3 ± 11.6; group III 71.5 ± 10.0) (p < 0.001). Patients with COPD highest rated their quality of life in the domain of social relationships 46.7 ± 19.6, and lowest in the domain of physical health 68.8 ± 18.4. Conclusions: Acceptance of the disease has a significant impact on the level of assessment of quality of life in patients with COPD—the higher acceptance, the higher rating of quality of life. Full article

162 KiB

Open AccessArticle

Abnormalities in Lung Volumes and Airflow in Children with Newly Diagnosed Connective Tissue Disease

by Joanna Peradzyńska, Katarzyna Krenke, Anna Szylling, Beata Kołodziejczyk, Agnieszka Gazda, Lidia Rutkowska-Sak and Marek Kulus

Adv. Respir. Med. 2016, 84(1), 22-28; https://doi.org/10.5603/PiAP.a2015.0081 - 17 Dec 2015

Cited by 1 | Viewed by 345

Abstract

Introduction: Connective tissue diseases (CTDs) of childhood are rare inflammatory disorders, involving various organs and tissues including respiratory system. Pulmonary involvement in patients with CTDs is uncommon but may cause functional impairment. Data on prevalence and type of lung function abnormalities in [...] Read more.

Introduction: Connective tissue diseases (CTDs) of childhood are rare inflammatory disorders, involving various organs and tissues including respiratory system. Pulmonary involvement in patients with CTDs is uncommon but may cause functional impairment. Data on prevalence and type of lung function abnormalities in children with CTDs are scarce. Thus, the aim of this study was to asses pulmonary functional status in children with newly diagnosed CTD and follow the results after two years of the disease course. Material and methods: There were 98 children (mean age: 13 ± 3; 76 girls), treated in Department of Pediatric Rheumatology, Institute of Rheumatology, Warsaw and 80 aged-matched, healthy controls (mean age 12.7 ± 2.4; 50 girls) included into the study. Study procedures included medical history, physical examination, chest radiograph and PFT (spirometry and whole body-plethysmography). Then, the assessment of PFT was performed after 24 months. Results: FEV₁, FEV₁/FVC and MEF50 were significantly lower in CTD as compared to control group, there was no difference in FVC and TLC. The proportion of patients with abnormal lung function was significantly higher in the study group, 41 (42%) vs. 9 (11%). 24-months observation didn’t reveal progression in lung function impairment. Conclusions: Lung function impairment is relatively common in children with CTDs. Although restrictive ventilatory pattern is considered typical feature of lung involvement in CTDs, airflow limitation could also be an initial abnormality. Full article

219 KiB

Open AccessCase Report

Pulmonary Lesions in the Course of Gastric Cancer—Two Cases of Bard’s Syndrome

by Michał Zieliński, Marek Ochman, Jan Głowacki and Jerzy Kozielski

Adv. Respir. Med. 2016, 84(1), 33-37; https://doi.org/10.5603/PiAP.a2015.0085 - 09 Nov 2015

Cited by 1 | Viewed by 335

Abstract

The Bard’s syndrome is a medical condition related to miliary dissemination of gastric cancer to the lungs. Difficulties in diagnosis are associated with the need of differentiation between numerous diseases, which may manifest as disseminated lesions in the lung parenchyma on chest radiograph. [...] Read more.

The Bard’s syndrome is a medical condition related to miliary dissemination of gastric cancer to the lungs. Difficulties in diagnosis are associated with the need of differentiation between numerous diseases, which may manifest as disseminated lesions in the lung parenchyma on chest radiograph. Despite the advanced proliferative process, primary focus of neoplasm frequently remains subclinical. Metastatic lesions cause many symptoms in the respiratory system, suggesting primary pulmonary pathology. The Bard’s syndrome should be always taken into account in differential diagnosis of disseminated lesions, particularly due to prevalence of gastric cancer. The study presents two cases of patients with disseminated pulmonary lesions, corresponding to gastric cancer metastases on radiological imaging. Full article

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Adv. Respir. Med., Volume 84, Issue 1 (January 2016) – 9 articles , Pages 1-61

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