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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 85, Issue 6 (December 2017) – 12 articles , Pages 294-358

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110 KiB  
Editorial
Rare Lung Diseases―Should We Pay More Attention?
by Elżbieta Radzikowska
Adv. Respir. Med. 2017, 85(6), 295-296; https://doi.org/10.5603/ARM.2017.0050 - 29 Dec 2017
Viewed by 291
Abstract
Rare diseases are defined as the diseases that affect less than one person in 2000 people [...] Full article
69 KiB  
Letter
Letter from the Editor
by Wojciech J. Piotrowski
Adv. Respir. Med. 2017, 85(6), 294; https://doi.org/10.5603/ARM.56991 - 20 Dec 2017
Viewed by 251
Abstract
This is a great pleasure to announce, that Advances in Respiratory Medicine has been recently approved for Emerging Sources Citation Index (ESCI) [...] Full article
222 KiB  
Article
The Utility of Selected Questionnaires in the Assessment of Fatigue, Depression and Health Quality in Post-Sarcoidosis Fatigue Syndrome
by Witold Górski, Łukasz Mokros, Anna Kumor-Kisielewska, Tadeusz Pietras and Wojciech J. Piotrowski
Adv. Respir. Med. 2017, 85(6), 313-321; https://doi.org/10.5603/ARM.2017.0054 - 18 Dec 2017
Cited by 11 | Viewed by 371
Abstract
Introduction: The nature of post-sarcoidosis fatigue syndrome (PSFS) is unknown and tools for the assessment of health quality (HQ) in these patients have not been fully assessed. The aim was to validate the Polish version of sarcoidosis health questionnaire (SHQ) and verify [...] Read more.
Introduction: The nature of post-sarcoidosis fatigue syndrome (PSFS) is unknown and tools for the assessment of health quality (HQ) in these patients have not been fully assessed. The aim was to validate the Polish version of sarcoidosis health questionnaire (SHQ) and verify the association of HQ with fatigue and depressive symptoms among Polish patients with PSFS. Material and methods: 71 patients with sarcoidosis (34 women, the mean age 47) were divided to: PSFS (n = 21), active sarcoidosis (S-A, n = 27) and sarcoidosis with complete remission (S-R, n = 23) groups. Fatigue Assessment Scale (FAS) was used to define significant fatigue (≥22 points). Polish version of SHQ was prepared by the authors and validated. Beck Depression Index (BDI) and Patient Health Questionnaire 9 (PHQ-9) were used to evaluate self-reported depressive symptoms. Results: Polish version of SHQ was proved reliable and valid. HQ was worse and depressive symptoms were more frequent in PSFS and S-A when compared with S-R group. SHQ total score correlated negatively with depressive symptoms (r = −0.787 for BDI and r = −0.755 for PHQ-9, p < 0.01). A negative correlation between SHQ and FAS score was found (r = –0.784, p < 0.01). FAS score correlated with depressive symptoms (r = 0.726 for BDI and r = 0.755 for PHQ-9, p < 0.01). Conclusion: Polish version of SHQ is a valuable tool for the assessment of HQ in sarcoidosis. HQ is impaired in PSFS comparing to patients with complete remission, but is comparable to active sarcoidosis. Depressive symptoms impact HQ and may influence perception of fatigue. Both fatigue and depression have a negative impact on HQ in sarcoidosis. Full article
179 KiB  
Review
Kyphoscoliosis—What Can We Do for Respiration besides NIV?
by Mateusz Pajdziński, Paulina Młynarczyk, Joanna Miłkowska-Dymanowska, Adam J. Białas, Moin Aldin Muhammad Afza, Wojciech J. Piotrowski and Paweł Górski
Adv. Respir. Med. 2017, 85(6), 352-358; https://doi.org/10.5603/ARM.2017.0060 - 14 Dec 2017
Cited by 6 | Viewed by 472
Abstract
Kyphoscoliosis is a significant clinical problem with no precise Guideliness for management, especially concerning respiratory pathology. No exhaustive systematic review has yet been performed. The aim was to conduct a systematic review of available data concerning the pathophysiology and treatment of kyphoscoliosis. An [...] Read more.
Kyphoscoliosis is a significant clinical problem with no precise Guideliness for management, especially concerning respiratory pathology. No exhaustive systematic review has yet been performed. The aim was to conduct a systematic review of available data concerning the pathophysiology and treatment of kyphoscoliosis. An electronic systematic search compliant with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Guideliness was conducted. The Pubmed database was examined and the search was updated to November 10, 2016. In total, 188 articles were screened, and 52 full text articles were then assessed for eligibility. As 24 of them met exclusion criteria, only 28 articles were further analysed. These articles were published in 18 journals from 1959 to 2015, with 25 being original studies, and one randomised control trial. The total corpus included 18 prospective studies, 7 retrospective studies and 3 Case Reports. KS is a significant complex, multidisciplinary clinical problem. The heterogeneous nature of the majority of published studies prevents unequivocal conclusions being drawn. Despite a great progress in knowledge about the respiratory system functioning and pathology in KS, the treatment seems to be not yet quite yet satisfactory. Therefore, there is a strong need for large prospective studies and unified clinical Guideliness in on the management of this group of patients. Full article
385 KiB  
Review
Solitary Pulmonary Nodule—The Role of Imaging in the Diagnostic Process
by Marcin Paśnik, Iwona Bestry and Kazimierz Roszkowski-Śliż
Adv. Respir. Med. 2017, 85(6), 345-351; https://doi.org/10.5603/ARM.2017.0059 - 14 Dec 2017
Cited by 5 | Viewed by 515
Abstract
A solitary pulmonary nodule is a round opacity less than 30 mm in diameter surrounded by normally aerated lung tissue. Determination of the character of the lesion following its detection (particularly when the identification was incidental) may require a complex diagnostic process. In [...] Read more.
A solitary pulmonary nodule is a round opacity less than 30 mm in diameter surrounded by normally aerated lung tissue. Determination of the character of the lesion following its detection (particularly when the identification was incidental) may require a complex diagnostic process. In most cases, nodules are benign in character; however, the probability of malignancy increases significantly for part-solid lesions. The main features that describe the solitary pulmonary nodule in computed tomography scans include their size, shape, density, presence of calcification and rate of growth. PET-CT examination provides additional information on the metabolic activity of the lesions, and MRI is helpful in assessment of local invasion of surrounding structures. Due to limited availability and highly specialized character, these examinations are not routinely used. Therefore, despite development of other imaging modalities, computed tomography remains the most important and crucial diagnostic tool. Clinical risk factors such as age or smoking status are very important for evaluation of the likelihood of malignancy of a nodular lesion. Due to the multidisciplinary nature of data required for complex assessment of a solitary nodular lesion, management routines are needed in the diagnostic process such as those proposed by the Fleischner Society. Full article
263 KiB  
Case Report
Actively Caseating Endobronchial Tuberculosis Successfully Treated with Intermittent Chemotherapy without Corticosteroid: A Report of 2 Cases
by Manoj Kumar Panigrahi, Gourahari Pradhan, Pritinanda Mishra and Prasanta Raghab Mohapatra
Adv. Respir. Med. 2017, 85(6), 322-327; https://doi.org/10.5603/ARM.2017.0055 - 14 Dec 2017
Viewed by 284
Abstract
Tuberculous infection of the tracheobronchial tree confirmed by microbiological or histopathological evidence with or without parenchymal involvement is known as endobronchial tuberculosis. Chronic cough is the predominant symptom. Expectorated sputum examination for acid fast bacilli is often negative leading to delay in diagnosis. [...] Read more.
Tuberculous infection of the tracheobronchial tree confirmed by microbiological or histopathological evidence with or without parenchymal involvement is known as endobronchial tuberculosis. Chronic cough is the predominant symptom. Expectorated sputum examination for acid fast bacilli is often negative leading to delay in diagnosis. Therefore, bronchoscopy is crucial for early diagnosis and evaluation of the extent of disease. Bronchostenosis is a significant complication of endobronchial tuberculosis that may be present at the time of diagnosis or develops during the course of treatment. Previously, corticosteroids have been used along with antitubercular therapy to prevent or reduce the extent of bronchostenosis; however, their role is debatable as bronchostenosis often develops despite the use of corticosteroids. Furthermore, the duration of treatment varied from 6–9 months of daily therapy in previous series and little is known about efficacy of intermittent antituberculous therapy. Here we report two cases of actively caseating endobronchial tuberculosis successfully managed with six months of intermittent oral antitubercular therapy without corticosteroids. Full article
201 KiB  
Article
Histone Deacetylases Affect Transcriptional Regulation of CCL2 and CXCL8 Expression by Pulmonary Fibroblasts In Vitro
by Paweł Golec, Paweł Bernatowicz, Grażyna Tokajuk, Mirosław Kozłowski and Krzysztof Kowal
Adv. Respir. Med. 2017, 85(6), 307-312; https://doi.org/10.5603/ARM.2017.0053 - 14 Dec 2017
Cited by 1 | Viewed by 383
Abstract
Introduction: Chemokines have been shown to play an important role in tissue remodeling and fibrosis in the respiratory system. In this study we wanted to evaluate the mechanisms, which regulate the expression of selected chemokines by pulmonary fibroblasts in vitro. Material and [...] Read more.
Introduction: Chemokines have been shown to play an important role in tissue remodeling and fibrosis in the respiratory system. In this study we wanted to evaluate the mechanisms, which regulate the expression of selected chemokines by pulmonary fibroblasts in vitro. Material and methods: Pulmonary fibroblasts were cultured with and without bacterial lipopolysaccharide (LPS) for 6 hours. In addition some of the cultures were pre-treated with histone deacetylase inhibitor Trichostatin A (TSA). Real-time PCR reaction was performed to estimate the expression of chemokines CCL2, CCL3 and CXCL8. Results: In unstimulated cultures detectable expression of CCL2 and CXCL8 was observed, while CCL3 expression could not be detected. After stimulation with LPS, TSA and both agents together CCL2 expression rose by 1.52, 1.62 and 1.8 times in comparison to control cultures respectively. CXCL8 mRNA expression levels after stimulation with LPS, TSA and LPSTSA increased by 1.53, 1.91 and 2.4 times accordingly. Conclusion: Epigenetic mechanisms related to histone acetylation affects transcriptional regulation of CCL2 and CXCL8 expression by pulmonary fibroblasts. Those mechanisms may play a role in tissue repair and pathologic remodeling. Full article
175 KiB  
Case Report
Dyspnoea, Cyanosis and Digital Clubbing in a 28-Year-Old Patient as a Result of Hepatopulmonary Syndrome
by Michał Zieliński, Marek Hartleb, Piotr Sitek and Dariusz Ziora
Adv. Respir. Med. 2017, 85(6), 339-344; https://doi.org/10.5603/ARM.2017.0058 - 13 Dec 2017
Cited by 2 | Viewed by 320
Abstract
This paper presents a case of a young patient with cyanosis and digital clubbing, until then an active, sporty person. He sought medical assistance due to the growing dyspnoea and the drop of effort tolerance. Initially the diagnostic process focused on the confirmation [...] Read more.
This paper presents a case of a young patient with cyanosis and digital clubbing, until then an active, sporty person. He sought medical assistance due to the growing dyspnoea and the drop of effort tolerance. Initially the diagnostic process focused on the confirmation of the suspicion of pulmonary fibrosis or another interstitial lung disease as causes of the respiratory failure. Due to the atypical presentation of the symptoms, reaching the final diagnosis of digestive system disease with lung involvement required a more thorough multifaceted diagnostics of a number of systems and organs. Full article
260 KiB  
Case Report
Spontaneous Resolution of Nitrofurantoin-Induced Chronic Pulmonary Toxicity Presenting with Respiratory Failure
by Elias Mir, Javed A. Malik, Shabir A. Lone, Ramees Mohi-ud-din and Majid Khalil
Adv. Respir. Med. 2017, 85(6), 333-338; https://doi.org/10.5603/ARM.2017.0057 - 13 Dec 2017
Cited by 7 | Viewed by 476
Abstract
Nitrofurantoin is one of the most common drugs implicated in drug-induced pulmonary toxicities, the manifestations of which range from dose-independent acute self-limiting reactions to chronic dose-dependent pathologies. The severity of these pulmonary adverse effects may range from trivial hypersensitivity reactions to extensive and [...] Read more.
Nitrofurantoin is one of the most common drugs implicated in drug-induced pulmonary toxicities, the manifestations of which range from dose-independent acute self-limiting reactions to chronic dose-dependent pathologies. The severity of these pulmonary adverse effects may range from trivial hypersensitivity reactions to extensive and irreversible lung fibrosis leading to respiratory failure and death. Symptomatic and supportive treatment in addition to discontinuation of the drug usually suffices for the management of mild reactions. Corticosteroids have been traditionally used to relieve the symptoms and hasten the resolution of pulmonary lesions in case of severe toxicities. However conclusive evidence in the form of controlled studies in favor of this routine use is lacking. We report a case of an elderly lady who presented to us in respiratory failure due to nitrofurantoin induced chronic lung disease. The patient’s symptoms and blood gas abnormalities resolved spontaneously over the course of 6 months after stopping the drug. Radiological lesions including those suggestive of apparently permanent fibrosis also resolved during this time. Corticosteroids, inhalational or systemic, were not used. Spontaneous normalization of clinico-radiological features in nitrofurantoin induced chronic lung disease presenting with respiratory failure has rarely been reported previously. The related literature is also reviewed. Full article
222 KiB  
Case Report
Diffuse Alveolar Haemorrhage Complicated by Pulmonary Embolism—Problems with Treatment
by Justyna Fijołek, Elzbieta Wiatr, Lilia Jakubowska, Malgorzata Polubiec-Kownacka, Pawel Kuca and Kazimierz Roszkowski-Sliz
Adv. Respir. Med. 2017, 85(6), 328-332; https://doi.org/10.5603/ARM.2017.0056 - 13 Dec 2017
Cited by 2 | Viewed by 387
Abstract
Diffuse alveolar haemorrhage (DAH) refers to a clinical syndrome resulting from injury of the alveolar capillaries, arterioles and venules leading to red blood cel accumulation in the distal air spaces. The conditions associated with DAH and underlying disease determine the prognosis and the [...] Read more.
Diffuse alveolar haemorrhage (DAH) refers to a clinical syndrome resulting from injury of the alveolar capillaries, arterioles and venules leading to red blood cel accumulation in the distal air spaces. The conditions associated with DAH and underlying disease determine the prognosis and the treatment regimen. The coexistence of DAH with venous thromboembolism (VTE) is a seroius problem for clinicians and poses a challenge in the therapeutic management. We describe a young patient who developed massive DAH in the course of anti-glomerular basement membrane (anti-GBM) disease (formerly called Goodpasture’s syndrome) complicated by pulmonary embolism (PE). Full article
190 KiB  
Article
Cryobiopsy versus Forceps Biopsy in Endobronchial Lesions, Diagnostic Yield and Safety
by Ahmed Ehab, Mohammad Khairy El-Badrawy, Amr Abdelhamed Moawad and Mohammad El-Dosouky Abo-Shehata
Adv. Respir. Med. 2017, 85(6), 301-306; https://doi.org/10.5603/ARM.2017.0052 - 06 Dec 2017
Cited by 18 | Viewed by 580
Abstract
Introduction: This study aimed to evaluate the safety and diagnostic yield of CB in comparison to forceps biopsy in endobronchial lesions. Material and methods: Patients with suspected endobronchial lesions were enrolled. Two forceps biopsies and one cryobiopsy were done in the [...] Read more.
Introduction: This study aimed to evaluate the safety and diagnostic yield of CB in comparison to forceps biopsy in endobronchial lesions. Material and methods: Patients with suspected endobronchial lesions were enrolled. Two forceps biopsies and one cryobiopsy were done in the same patient with randomized sequence. The largest diameter of the samples was measured in mm by electronic caliper. Diagnostic yield of each technique and postbronchoscopy bleeding were evaluated. Results: Samples obtained by CB was significantly larger than that of the forceps biopsy (5.9 ± 2.3 vs 2.5 ± 0.8), (p = 0.001). Diagnostic yield of CB was significantly higher than forceps biopsy 74.5% versus 51.1% (p = 0.001). Mild and moderate bleeding grades were reported in both techniques with no significant difference (p = 0.063) (p = 0.5) respectively. Severe bleeding was not recorded in both techniques. Conclusions: CB represents a safe and effective tool to obtain a larger tissue samples of a good quality with higher diagnostic yield in comparison to standard forceps samples. On the other hand, bleeding occurred more frequently after CB than forceps biopsy. However, without severe adverse effects. Full article
144 KiB  
Communication
Pulmonary Langerhans Cell Histiocytosis—Insight into the Incidence of Alfa-1-Antitrypsin Deficiency (A1ATD) Alleles
by Elżbieta Radzikowska, Radosław Struniawski, Joanna Chorostowska-Wynimko, Elżbieta Wiatr and Kazimierz Roszkowski-Śliż
Adv. Respir. Med. 2017, 85(6), 297-300; https://doi.org/10.5603/ARM.2017.0051 - 05 Dec 2017
Cited by 2 | Viewed by 394
Abstract
Introduction: The alpha-1 antitrypsin deficiency (A1ATD) is one of the three most common genetic disorders in Caucasians. It considerably increases the risk of progressive obstructive lung diseases, mostly chronic obstructive pulmonary disease. There is no data regarding the prevalence of main, clinically [...] Read more.
Introduction: The alpha-1 antitrypsin deficiency (A1ATD) is one of the three most common genetic disorders in Caucasians. It considerably increases the risk of progressive obstructive lung diseases, mostly chronic obstructive pulmonary disease. There is no data regarding the prevalence of main, clinically most important A1ATD alleles PI*Z and PI*S in patients with pulmonary Langerhans cell histiocytosis (PLCH). PLCH is not only strongly linked to the cigarette smoking, but is also characterised by polycystic lung lesions. The goal of the study was to assess the incidence of A1ATD alleles in patients with PLCH. Material and methods: Blood samples were collected from 34 adult patients (14 women and 20 men), with histologically confirmed PLCH. AAT serum concentration was assessed by nephelometry and PI-phenotype, identified by isoelectrofocusing. The PI*S and PI*Z alleles were confirmed by genotyping using real-time PCR. Results: Deficiency alleles PI*Z and PI*S were detected in 3 patients (one woman and 2 men), in 5.88% and 2.94%. The estimated incidence of deficiency alleles was 29.4/1000 (95% CI; 10–69.5) for PI*Z and 14.7/1000 (95%CI; 13.9–43.3) for PI*S. According to our previous reports, the expected prevalence of PI*Z and PI*S alleles in the general Polish population was 13.7/1000 (95% CI 5.8–21.5), and 7.6/1000 (95% CI 1.7–13.5) respectively. Conclusions: The incidence of main A1AT deficiency alleles in patients with PLCH seems higher than in the general Polish population. The study is ongoing. Full article
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