Advances in Respiratory Medicine

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Open AccessLetter

Network of Breathing. Multifunctional Role of the Diaphragm: A Review

by Bruno Bordoni

Adv. Respir. Med. 2017, 85(5), 290-291; https://doi.org/10.5603/ARM.a2017.0047 - 30 Oct 2017

Cited by 1 | Viewed by 505

Abstract

I read with interest the item by Kocjan and collegues [...] Full article

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Open AccessReview

Pulmonary Langerhans' Cell Histiocytosis in Adults

by Elżbieta Radzikowska

Adv. Respir. Med. 2017, 85(5), 277-289; https://doi.org/10.5603/ARM.a2017.0046 - 30 Oct 2017

Cited by 30 | Viewed by 1068

Abstract

Pulmonary Langerhans' cell histiocytosis (PLCH) is a rare disorder of unknown cause characterised by the infiltration of the lungs and other organs by the bone marrow derived Langerhans' cells, which carry mutations of BRAF gene and/or NRAS, KRAS and MAP2K1 genes. It occurs [...] Read more.

Pulmonary Langerhans' cell histiocytosis (PLCH) is a rare disorder of unknown cause characterised by the infiltration of the lungs and other organs by the bone marrow derived Langerhans' cells, which carry mutations of BRAF gene and/or NRAS, KRAS and MAP2K1 genes. It occurs predominantly in young smokers, without gender predominance. The disease is characterised by formation of eosinophilic granulomas with the presence of Langerhans' cells infiltrating and destroying distal airways. High-resolution computed tomography of the chest (HRCT) plays an outstanding role in PLCH diagnosis. The typical radiological picture of PLCH is the presence of small intralobular nodules, often forming 'tree in bud' lesions, cavitated nodules, thin- and thick-walled cystic lesions frequently confluent. Definite diagnosis requires the finding of characteristic lesions in histological examination and demonstration of antigen CD1a or CD207 presenting cells in immunohistochemistry. Smoking cessation is the most important recommendation for PLCH patients. There are no evidence based data regarding systemic steroid therapy. The treatment of progressive PLCH is based on cladribine or cytarabine as salvage therapy. The prognosis is good, and over 85% of patients survive 10 years. Full article

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Open AccessReview

Eosinophilic COPD―A Distinct Phenotype of the Disease

by Damian Tworek and Adam Antczak

Adv. Respir. Med. 2017, 85(5), 271-276; https://doi.org/10.5603/ARM.a2017.0045 - 30 Oct 2017

Cited by 9 | Viewed by 658

Abstract

Chronic Obstructive Pulmonary Disease (COPD) has been traditionally associated with neutrophilic inflammation of the bronchi. Studies from the early 1990s demonstrated that eosinophils may also migrate into the lower airways of patients with COPD and their increased numbers can be noticed during exacerbations [...] Read more.

Chronic Obstructive Pulmonary Disease (COPD) has been traditionally associated with neutrophilic inflammation of the bronchi. Studies from the early 1990s demonstrated that eosinophils may also migrate into the lower airways of patients with COPD and their increased numbers can be noticed during exacerbations as well as stable disease. Eosinophilic phenotype of COPD is characterized by several unique features, i.e., a specific pattern of airway inflammation and distinct clinical course or susceptibility to corticosteroid treatment. In this paper, we present an up-to-date review of the literature on clinical characteristics of eosinophilic COPD, as well as the role of eosinophils as a biomarker-guided therapy in COPD. Full article

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Open AccessReview

Predictors of Noninvasive Ventilation Failure in Critically Ill Obese Patients: A Brief Narrative Review

by Antonello Nicolini, Malcom Lemyze, Antonio Esquinas, Cornelius Barlascini and Maurizio Alessandro Cavalleri

Adv. Respir. Med. 2017, 85(5), 264-270; https://doi.org/10.5603/ARM.a2017.0044 - 30 Oct 2017

Cited by 7 | Viewed by 498

Abstract

Non-invasive ventilation ( NIV ) has been used successfully for the management of acute respiratory failure (ARF) more often in the last two decades than previously. Unfortunately, NIV can have failure rates ranging from 5% to 50% and patient selection is the key [...] Read more.

Non-invasive ventilation ( NIV ) has been used successfully for the management of acute respiratory failure (ARF) more often in the last two decades than previously. Unfortunately, NIV can have failure rates ranging from 5% to 50% and patient selection is the key to success. There are particular groups of patients that are more likely to benefit from NIV. For patients with hypoventilation syndrome (OHS) this treatment can be beneficial. This review seeks to evaluate the effectiveness of NIV in acute ARF and determine predictors of NIV failure in morbidly obese patients. Only a few studies have investigated NIV success or failure in these patients. NIV was most often effective when patients were carefully selected. Obese patients who exhibited early NIV failure had a high severity score at admission. In contrast, more than half of hypercapnic patients with decompensated OHS exhibited a delayed but successful response to NIV. Patients with decompensation of OHS had better prognosis and response to NIV than other hypercapnic patients. They required more aggressive NIV settings, a longer time to reduce paCO₂ levels , and more frequently a delayed but successful response to NIV which should encourage the use of NIV rather than early intubation. Since clear predictors of NIV failure have not been identified, a strict and prolonged monitoring is mandatory. Full article

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Open AccessCase Report

Sarcoidosis-Associated Pulmonary Hypertension Treated with Sildenafil

by Aneta Kacprzak, Monika Szturmowicz, Barbara Burakowska, Monika Franczuk, Jarosław Kober, Marcin Kurzyna, Michał Wilk, Sebastian Szmit, Adam Torbicki and Jan Kuś

Adv. Respir. Med. 2017, 85(5), 258-263; https://doi.org/10.5603/ARM.a2017.0043 - 30 Oct 2017

Cited by 5 | Viewed by 331

Abstract

Development of sarcoidosis-associated pulmonary hypertension (SAPH) significantly worsens prognosis in sarcoidosis patients. Unfortunately, there is no treatment of proven benefit for this condition. Medications used for treatment of pulmonary arterial hypertension are of great interest in this respect. Here, we report a case [...] Read more.

Development of sarcoidosis-associated pulmonary hypertension (SAPH) significantly worsens prognosis in sarcoidosis patients. Unfortunately, there is no treatment of proven benefit for this condition. Medications used for treatment of pulmonary arterial hypertension are of great interest in this respect. Here, we report a case of a patient with severe SAPH treated with sildenafil. A significant, but only temporary improvement in functional status was observed, and the patient died of gradually progressing heart and respiratory failure while awaiting for lung transplantation. Full article

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Open AccessCase Report

Pulmonary Function Tests Leading to the Diagnosis of Vascular Malformations in School-Aged Children

by Beata Kusak, Ewa Cichocka-Jarosz, Urszula Jedynak-Wąsowicz and Grzegorz Lis

Adv. Respir. Med. 2017, 85(5), 253-257; https://doi.org/10.5603/ARM.a2017.0042 - 30 Oct 2017

Cited by 4 | Viewed by 327

Abstract

Vascular rings are congenital defects of great vessels. They cause compression of the trachea or/and the esophagus and therefore result in symptoms like inspiratory stridor, cough, wheezing, recurrent respiratory tract infections or dysphagia. In some cases, the correct diagnosis can be delayed for [...] Read more.

Vascular rings are congenital defects of great vessels. They cause compression of the trachea or/and the esophagus and therefore result in symptoms like inspiratory stridor, cough, wheezing, recurrent respiratory tract infections or dysphagia. In some cases, the correct diagnosis can be delayed for many years, especially when vascular rings produce less severe symptoms or symptoms mimicking other diseases (most of all asthma). In this article, we would like to emphasis the usefulness of pulmonary function test (spirometry) in the initial diagnosis of vascular rings in school-aged children, as well as the importance of spirometry in evaluating patients with asthma presumption. Full article

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Open AccessCase Report

Video-Assisted Thoracoscopic Bronchial Sleeve Lobectomy

by Marcin Ostrowski, Tomasz Marjański and Witold Rzyman

Adv. Respir. Med. 2017, 85(5), 250-252; https://doi.org/10.5603/ARM.a2017.0041 - 30 Oct 2017

Cited by 2 | Viewed by 364

Abstract

Bronchial sleeve lobectomy offers a chance to avoid excessive resections such as pneumonectomy in central lung tumors. Recent technical advances enable complex procedures such as video-assisted thoracoscopic bronchial sleeve lobectomy (VABSL). We present a case of a 64-year-old patient who underwent the right [...] Read more.

Bronchial sleeve lobectomy offers a chance to avoid excessive resections such as pneumonectomy in central lung tumors. Recent technical advances enable complex procedures such as video-assisted thoracoscopic bronchial sleeve lobectomy (VABSL). We present a case of a 64-year-old patient who underwent the right upper VABSL due to adenocarcinoma. During resection the bronchus was transsected and a specimen removed due to tumor proximity. Intraoperative frozen section revealed no neoplastic infiltration in the bronchial cut line. Due to a stiff round shape of the bronchial defect, impossible to approximate by direct suturing without kinking, sleeve lobectomy was undertaken. Bronchial section was performed through utility incision partly under direct vision. End-to-end anastomosis was led with open surgery needle holder, forceps and with continuous Maxon 4–0. Postoperative stay was uncomplicated and bronchoscopy revealed wide lumen of anastomosis. Full article

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Open AccessCase Report

Spontaneous Regression of FDG/PET Positive Lung Adenocarcinoma in an Elderly Man

by Yukari Miyoshi, Norio Takayashiki and Hiroaki Satoh

Adv. Respir. Med. 2017, 85(5), 246-249; https://doi.org/10.5603/ARM.a2017.0040 - 30 Oct 2017

Cited by 3 | Viewed by 268

Abstract

Spontaneous cancer regression, either partial or complete, is a rare phenomenon, particularly in patients with lung cancer. The present paper is the Case Report of an elderly lung cancer patient aged 80 who exhibited spontaneous regression of the primary lesion, without receiving any [...] Read more.

Spontaneous cancer regression, either partial or complete, is a rare phenomenon, particularly in patients with lung cancer. The present paper is the Case Report of an elderly lung cancer patient aged 80 who exhibited spontaneous regression of the primary lesion, without receiving any treatment. Spontaneous regression commenced two years after obtaining pathological specimens by transbronchial biopsy from the pulmonary lesion. It is interesting that the tumor lesion had a strong uptake (standardized uptake value max: 26.3) in ¹⁸fluorodeoxyglucose positron-emission tomography before biopsy and that the regression occurred after a long interval after the biopsy, and that the regression developed in an elderly man. It is unknown why spontaneous regression was observed in this case and what kind of mechanism was involved in the phenomenon. Even in the elderly, as observed in our case, spontaneous regression can occur. The patient should be closely followed up to monitor the clinical course of such an unusual phenomenon. Full article

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Open AccessArticle

Pulmonary Prevention Program in the Proszowice County: Description and Results

by Wojciech Skucha, Filip Mejza, Paweł Nastałek and Zbigniew Doniec

Adv. Respir. Med. 2017, 85(5), 239-245; https://doi.org/10.5603/ARM.a2017.0039 - 30 Oct 2017

Cited by 3 | Viewed by 322

Abstract

Introduction: In the Proszowice county, both lung cancer and chronic obstructive pulmonary disease (COPD) are more common in comparison with other regions of Poland. The purpose of this paper was to provide a report on a prevention program carried out in the [...] Read more.

Introduction: In the Proszowice county, both lung cancer and chronic obstructive pulmonary disease (COPD) are more common in comparison with other regions of Poland. The purpose of this paper was to provide a report on a prevention program carried out in the area to reduce the burden of COPD and lung cancer in the region. Material and methods: The program consisted of the following: active prevention―questionnaire survey offered to every county inhabitant aged at least 40 and chest X-ray and spirometry performed in selected subjects; and passive prevention―covering multiple educational activities promoting healthy lifestyle. Data obtained from questionnaire survey and spirometry were further analyzed. Results: Education program covered all local children aged 13–15, a majority of adolescents and a significant proportion of adult inhabitants of the county. Questionnaire data were obtained from 14,455 subjects (about 70% of county inhabitants). On the basis of the questionnaire results, the participants were selected to undergo spirometry (5816 subjects) and chest X-ray (5514 subjects). Current smokers constituted 24.2% of the total number of participants (33.3% of men and 16.8% of women). Electronic cigarettes were currently used by 0.65% of the subjects. Negative impact of occupational exposures (including farming) on lung function and the presence of respiratory symptoms was observed. Basing on post-bronchodilator spirometry, COPD was diagnosed in 13.2% of the subjects. Physician’s diagnosis of asthma was reported by 7.2%. Conclusion: Educational activities and questionnaire-based study were targeted at and reached the majority of the county inhabitants. The study provided data on the prevalence and risk factors of COPD, asthma and respiratory symptoms in the Proszowice region. Full article

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Open AccessArticle

Comparison of Lung Function Values of Trained Divers in 1.5 ATA Hyperbaric Chamber after Inhaling 100% Oxygen and Regular Air: A Crossover Study

by Muhammad Irfan Ilmi, Faisal Yunus, Mohammad Guritno Suryokusumo, Triya Damayanti, Erlang Samoedro, Ahmad Muslim Nazaruddin and Fariz Nurwidya

Adv. Respir. Med. 2017, 85(5), 233-238; https://doi.org/10.5603/ARM.a2017.0038 - 30 Oct 2017

Cited by 3 | Viewed by 393

Abstract

Introduction: Diving is an activity performed in more than 1 atmosphere absolute pressure (ATA) either underwater or in a hyperbaric chamber. We aimed to compare lung function values of trained divers in 1.5 ATA hyperbaric chambers after inhaling 100% oxygen and regular [...] Read more.

Introduction: Diving is an activity performed in more than 1 atmosphere absolute pressure (ATA) either underwater or in a hyperbaric chamber. We aimed to compare lung function values of trained divers in 1.5 ATA hyperbaric chambers after inhaling 100% oxygen and regular air. Methods: This experimental study with crossover design involved 18 trained divers in 1.5 ATA hyperbaric room, which is equivalents to a 5-meter depth. The eighteen subjects as the supplementation group, using oro-nasal mask, inhaled 100% oxygen for 30 min followed by a one-day washout period. The subjects were then crossed-over into control group inhaling only regular air for 30 min. Lung function test was performed before and after supplementation. Results: In eighteen subjects inhaling regular air, there was a significant difference (p < 0.05) in FEV₁/FVC, PEF, FEF25, FEF50, and FEF75. Whereas in eighteen subjects inhaling 100% oxygen, significant difference (p < 0.05) was observed not only in FEV₁/FVC, PEF, FEF25, FEF50 and FEF75, but also in FEV₁. Conclusions: There were significant differences in lung function, especially in dynamic volume of trained divers in 1.5 ATA hyperbaric chamber after inhaling 100% oxygen and regular air for 30 min; while there were no significant differences in lung capacity (VC and FVC) in the both groups. Lung function returned to normal following supplementation with a 1-day washout period. Full article

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Open AccessLetter

Network of Breathing. Multifunctional Role of the Diaphragm: A review. Response to the Letter to Editor of Prof. Bordoni

by Janusz Kocjan, Mariusz Adamek, Bożena Gzik-Zroska, Damian Czyżewski and Mateusz Rydel

Adv. Respir. Med. 2017, 85(5), 292-293; https://doi.org/10.5603/ARM.a2017.0048 - 11 Mar 2017

Cited by 1 | Viewed by 589

Abstract

Thank you for the opportunity to respond to Professor Bordoni’s letter [...] Full article

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Adv. Respir. Med., Volume 85, Issue 5 (October 2017) – 11 articles , Pages 233-293

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