Advances in Respiratory Medicine

219 KiB

Open AccessReview

Respiratory System Involvement in Inflammatory Bowel Diseases

by Aneta Kacprzak, Monika Szturmowicz and Jan Kuś

Adv. Respir. Med. 2017, 85(3), 161-168; https://doi.org/10.5603/ARM.2017.0028 - 30 Jun 2017

Cited by 10 | Viewed by 438

Inflammatory bowel diseases are systemic disorders that can manifest in any location. The problem of respiratory system involvement is very important form clinical point of view. In the article we try to systematize the current knowledge on this topic. Full article

237 KiB

Open AccessArticle

Public Spirometry Campaign in Chronic Obstructive Pulmonary Disease Screening–Hope or Hype?

by Piotr Korczyński, Katarzyna Górska, Piotr Jankowski, Jakub Kosiński, Agata Kudas, Katarzyna Sułek, Maria Jankowska, Kaja Jaśkiewicz and Rafał Krenke

Adv. Respir. Med. 2017, 85(3), 143-150; https://doi.org/10.5603/ARM.2017.0024 - 30 Jun 2017

Cited by 3 | Viewed by 384

Abstract

Introduction: Underdiagnosis of COPD seems to be a relevant clinical and social problem. We hypothesized that active public spirometry campaign may help identify subjects with airflow limitation consistent with COPD. The aim of the study was (1) to evaluate the willingness of [...] Read more.

Introduction: Underdiagnosis of COPD seems to be a relevant clinical and social problem. We hypothesized that active public spirometry campaign may help identify subjects with airflow limitation consistent with COPD. The aim of the study was (1) to evaluate the willingness of random smokers to undergo public spirometry, (2) to assess the ability to obtain an acceptable quality spirometry during a public campaign, and (3) to assess the relationships between the presence and severity of respiratory symptoms and readiness to undergo spirometry. Material and methods: Pedestrians aged > 40 years and a smoking history > 10 pack-years were recruited by medical students to fill a questionnaire and perform spirometry. Those with obstructive or borderline ventilatory insuffciency were invited and encouraged to undergo stationary spirometry in a pulmonary outpatient department. Results: Nine hundred and five subjects meeting the inclusion criteria were invited to the study. Only 178 subjects agreed to complete the questionnaire and undergo spirometry. Airway obstruction and borderline spirometry result (classified as possible airway obstruction) were found in 22 and 37 subjects, respectively. Of these, only 15 patients attended follow-up visit to verify public spirometry results. Extrapolation of the limited data showed the incidence of newly diagnosed airway obstruction as 10.7%. Conclusions: Public spirometry campaign does not seem to be an effective way of COPD screening. Smokers are reluctant to undergo complimentary spirometry even in the presence of pronounced respiratory symptoms. Our observations may be helpful in elaborating future screening programs for COPD. Full article

632 KiB

Open AccessArticle

Occurrence of Bronchial Anthracofibrosis in Respiratory Symptomatics with Exposure to Biomass Fuel Smoke

by Vikas Pilaniya, Shekhar Kunal and Ashok Shah

Adv. Respir. Med. 2017, 85(3), 127-135; https://doi.org/10.5603/ARM.2017.0022 - 30 Jun 2017

Cited by 7 | Viewed by 400

Abstract

Introduction: Bronchial anthracofibrosis (BAF), confirmed bronchoscopically, is characterised by bluish-black mucosal pigmentation and distortion/narrowing of the bronchus. We investigated the occurrence of BAF in respiratory symptomatics with biomass fuel smoke exposure and evaluated its clinico-radiological attributes and impact on functional status. Material [...] Read more.

Introduction: Bronchial anthracofibrosis (BAF), confirmed bronchoscopically, is characterised by bluish-black mucosal pigmentation and distortion/narrowing of the bronchus. We investigated the occurrence of BAF in respiratory symptomatics with biomass fuel smoke exposure and evaluated its clinico-radiological attributes and impact on functional status. Material and methods: Of the eighty subjects evaluated, 60 consented for fiberoptic bronchoscopy (FOB). All 60 subjects also underwent chest radiography, high resolution computed tomography (HRCT) of the thorax, spirometry with reversibility testing and six-minute-walk test. Information regarding cardinal respiratory symptoms and duration of biomass fuel smoke exposure was documented. FOB evaluation revealed that 24 patients had BAF (Group 1), 17 had bronchial anthracosis (Group 2) and 19 had normal appearance (Group 3). Results: Group 1 patients had significantly higher biomass fuel smoke exposure (p < 0.0001) and lower walk distance (p = 0.003) with greater desaturation. On HRCT, segmental collapse and consolidation were significantly higher in Group 1 while fibrotic lesions were the predominantly seen in Groups 2 and 3. A significant inverse correlation in Group 1 was seen between exposure index, six-minute-walk distance and spirometric parameters. In Group 1, the right middle lobe (RML) bronchus was most commonly involved (15/24 [62.5%]). In Group 2, RML and left upper lobe bronchi were affected in 8/17 (47.1%) patients each. Conclusions: All patients in our study were females. Those with BAF had poorer functional status as compared to those with anthracosis only. On imaging, multifocal bronchial narrowing was specific to BAF.
Full article

308 KiB

Open AccessReview

Signaling Pathways and Their Mirna Regulators Involved in the Etiopathology of Idiopathic Pulmonary Fibrosis (IPF) and Hypersensitivity Pneumonitis (HP)

by Justyna Kiszałkiewicz, Wojciech J. Piotrowski and Ewa Brzeziańska-Lasota

Adv. Respir. Med. 2017, 85(3), 169-178; https://doi.org/10.5603/ARM.2017.0029 - 13 Jun 2017

Cited by 14 | Viewed by 607

Abstract

Idiopathic pulmonary fibrosis (IPF) and hypersensitivity pneumonitis (HP) belong to heterogenic group of interstitial lung diseases (ILD). For the reason that this group of diseases present with complex clinical non-specific features, they represent a diagnostic and therapeutic challenge. In this review we focus [...] Read more.

Idiopathic pulmonary fibrosis (IPF) and hypersensitivity pneumonitis (HP) belong to heterogenic group of interstitial lung diseases (ILD). For the reason that this group of diseases present with complex clinical non-specific features, they represent a diagnostic and therapeutic challenge. In this review we focus on several crucial signaling pathways participating in inflammation, fibrosis and EMT processes, so important in the course of ILD: TNF-α/NFκβ, TGF-β/SMAD, Wnt-β-catenin and PI3K-Akt signaling. Moreover, this review summarizes the role of selected signaling pathways and some miRNAs which are their regulators during development and progression of IPF and HP. Recent advances indicate the potential role of miRNAs as a molecular markers differentiating clinical course of ILD. Full article

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Open AccessCase Report

Tracheobronchopathia Osteochondroplastica—A 61-Year-Old Female with Middle Lobe Syndrome

by Mariusz S. Woźniak, Joachim Buchwald, Izabela Stockdale and Zbigniew Doniec

Adv. Respir. Med. 2017, 85(3), 158-160; https://doi.org/10.5603/ARM.2017.0027 - 13 Jun 2017

Cited by 5 | Viewed by 349

Abstract

The authors present a case of a 61-year-old female patient suffering from tracheobronchopathia osteochondroplastica (TBO). Etiology of this unit is uncertain. TBO is characterised by presence of multiple nodules of various size, situated in the submucosa of the trachea and major bronchi. The [...] Read more.

The authors present a case of a 61-year-old female patient suffering from tracheobronchopathia osteochondroplastica (TBO). Etiology of this unit is uncertain. TBO is characterised by presence of multiple nodules of various size, situated in the submucosa of the trachea and major bronchi. The course is usually benign, until lesion obstructs the bronchial lumen. In the presented case, occluded middle lobe bronchi resulted in peripheral atelectasis of the lung. Full article

1435 KiB

Open AccessCase Report

Tracheal Bronchus Presenting with Recurrent Haemoptysis in an Adult Female

by Manoj Kumar Panigrahi, Gourahari Pradhan and Prasanta Raghab Mohapatra

Adv. Respir. Med. 2017, 85(3), 155-157; https://doi.org/10.5603/ARM.2017.0026 - 13 Jun 2017

Cited by 1 | Viewed by 317

Abstract

Abnormal bronchus arising directly from the trachea or the main bronchus is a rare developmental anomaly of the tracheobronchial tree. In general, tracheal bronchus has been reported in less than 1% of adult patients undergoing bronchoscopy with a male predominance. Tracheal bronchus is [...] Read more.

Abnormal bronchus arising directly from the trachea or the main bronchus is a rare developmental anomaly of the tracheobronchial tree. In general, tracheal bronchus has been reported in less than 1% of adult patients undergoing bronchoscopy with a male predominance. Tracheal bronchus is classified as—‘displaced’ and ‘supernumerary’, the former being the most common type reported. Most patients are asymptomatic; however, cases presenting with cough, haemoptysis or recurrent lung infections are not uncommon. The diagnosis is usually made through computed tomography or bronchoscopy. Awareness of this anomaly may help in timely identification or prevention of perioperative complications during general anaesthesia or resectional thoracic surgery. Herein we report a case of right-sided displaced tracheal bronchus in an adult female presenting with recurrent haemoptysis. Full article

540 KiB

Open AccessCase Report

A Rare Case of Community Acquired Serratia Lung Abscess in a Patient with Cardiac Bronchus

by Mai Altous, Ayoub Innabi, Bashar Alzghoul, Kshitij Chatterjee, Nikhil Meena and Feras Hawari

Adv. Respir. Med. 2017, 85(3), 151-154; https://doi.org/10.5603/ARM.2017.0025 - 13 Jun 2017

Cited by 2 | Viewed by 295

Abstract

The incidence of lung abscess caused by Serratia marcescens is extremely low and is only reported in the immunocompromised population. We present a previously healthy woman with Serratia lung abscess in close proximity with an accessory cardiac bronchus. The patient was treated with [...] Read more.

The incidence of lung abscess caused by Serratia marcescens is extremely low and is only reported in the immunocompromised population. We present a previously healthy woman with Serratia lung abscess in close proximity with an accessory cardiac bronchus. The patient was treated with appropriate antibiotics which led to complete resolution of the lesion. Our case highlights that individuals without medical co-morbidities may develop atypical lung infections like Serratia when associated with anatomic anomalies. Full article

359 KiB

Open AccessArticle

Idiopathic Pulmonary Fibrosis (IPF)―Common Practice in Poland before the “Antifibrotic Drugs Era”

by Wojciech J. Piotrowski, Magdalena M. Martusewicz-Boros, Adam J. Białas and Katarzyna Lewandowska

Adv. Respir. Med. 2017, 85(3), 136-142; https://doi.org/10.5603/ARM.2017.0023 - 07 Jun 2017

Cited by 6 | Viewed by 378

Abstract

Introduction: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and debilitating lung disease with a median survival time of 3–5 years. For now, pirfenidone (PIR) and nintedanib (NTB) are the only drugs that can slow down the disease’s progression. In Poland, these [...] Read more.

Introduction: Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive and debilitating lung disease with a median survival time of 3–5 years. For now, pirfenidone (PIR) and nintedanib (NTB) are the only drugs that can slow down the disease’s progression. In Poland, these drugs, although registered for legal use, had not been reimbursed for IPF patients until the end of the year 2016. Aim of the study was to assess what was common practice in terms of diagnosis and treatment in the period before antifibrotic drugs became available for IPF patients in Poland. Material and methods: We performed a survey among participants of two nationwide pulmonological congresses held in 2016. Results: One hundred and fifty physicians took part in the study. Only 55% of respondents would reach their final diagnosis in collaboration with a radiologist. Just 40% of those sending patients for surgical lung biopsy (SLB) would discuss the case directly with a pathologist. 22% would never refer the patient suspected of having IPF for SLB. 85% believed that bronchoalveolar lavage (BAL) may be useful for diagnosis. 41% of respiratory professionals would not use any drug for the treatment of IPF patients. 23% of physicians would prescribe corticosteroids in high doses (CS), either in monotherapy or in combination with other drugs. Only 43% of respondents would use antacid drugs in case of symptomatic gastro-oesophageal reflux disease (GERD), and only 11% would prescribe these drugs regardless of GERD diagnosis. Conclusions: The majority of Polish pulmonologists were not supported by radiologists and pathologists in the diagnostic process. Treatment standards were unsatisfactory, mostly due to a lacking of reimbursement regulations. Further education is necessary to improve management of IPF patients in Poland. Full article

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Adv. Respir. Med., Volume 85, Issue 3 (June 2017) – 8 articles , Pages 127-178

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