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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 86, Issue 3 (June 2018) – 6 articles , Pages 113-157

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233 KiB

Open AccessGuidelines

Recommendations for the Management of Tuberculosis in Children—KOMPASS TB. Part 1: Tuberculosis Prevention

by Teresa Bielecka, Ewa Augustynowicz-Kopeć, Paweł Gonerko, Paweł Gruszczyński, Maria Korzeniewska-Koseła, Maria Krasińska, Katarzyna Krenke, Joanna Lange, Anna Pankowska, Marek Popielarz, Andrzej Pustkowski, Joanna Stryczyńska-Kazubska and Zbigniew Doniec

Adv. Respir. Med. 2018, 86(3), 149-157; https://doi.org/10.5603/ARM.2018.0023 - 30 Jun 2018

Cited by 6 | Viewed by 399

Abstract

Since the second half of the 20th century the incidence of tuberculosis has been declining in Poland. Despite this, current epidemiological data still support the need for the continued mass BCG vaccination in Poland in the near future. Apart from the protection against severe hematogenous forms of tuberculosis, vaccination lowers the risk of infection with Mycobacterium tuberculosis. Primary and acquired immunodeficiency, including immunity disorders associated with an ongoing treatment, are contraindications to BCG vaccination. The most common adverse effects following BCG vaccination are reactions at the site of injection and in regional lymph nodes, which usually does not require treatment. Methods of tuberculosis prevention, particularly recommended in low-incidence countries, include: diagnostic investigations of patients who had contacts with pulmonary tuberculosis as well as an active detection and treatment of latent Mycobacterium tuberculosis infection. Latent tuberculosis infection can be identified on the basis of positive results of the tuberculin skin test or interferon-gamma release assays after the active disease has been ruled out. This condition does require prophylactic treatment. Full article

218 KiB

Open AccessReview

Immune Checkpoint Inhibitors in Non-Small Cell Lung Cancer—Towards Daily Practice

by Joanna Domagała-Kulawik

Adv. Respir. Med. 2018, 86(3), 142-148; https://doi.org/10.5603/ARM.2018.0022 - 30 Jun 2018

Cited by 10 | Viewed by 546

Abstract

Immunotherapy with immune checkpoint inhibitors (ICIs) revolutionized therapy of solid tumors, among them- lung cancer. PD-1, PD-L1 blockers have been shown to improve overall survival in advanced, metastatic non-small cell lung cancer. In individual patients, 3-5-year survival has been achieved. Nivolumab, pembrolizumab, atezolizumab are approved in lung cancer treatment. Practical observations in reallife show that the results are comparable with those achieved in clinical trials. The effects of ICIs depend on the patient performance status; age, sex, histology; the presence of brain metastases have not modified treatment results. ICIs therapy is safe and well tolerated; immune related adverse events are observed. Pneumonitis may be a serious and fatal complication, but glucocorticoids are usually curative. For proper patients selection for ICIs treatment, the detection of PD-L1 expression on cancer cells is used. The so-called “hot” tumors with high expression of PD-L1 and abundant infiltration by cytotoxic cells seem to better respond to treatment than “cold” tumors. Full article

2648 KiB

Open AccessReview

Pulmonary Veno-Occlusive Disease: Pathogenesis, Risk Factors, Clinical Features and Diagnostic Algorithm—State of the Art

by Monika Szturmowicz, Aneta Kacprzak, Małgorzata Szołkowska, Barbara Burakowska, Ewa Szczepulska and Jan Kuś

Adv. Respir. Med. 2018, 86(3), 131-141; https://doi.org/10.5603/ARM.2018.0021 - 30 Jun 2018

Cited by 12 | Viewed by 757

Abstract

Pulmonary veno-occlusive disease (PVOD) and pulmonary capillary haemangiomatosis (PCH) are rare disorders, with the estimated prevalence of less than 1 case per million inhabitants. The vascular pathology in PVOD/PCH involves pre-septal and septal veins, alveolar capillaries and small pulmonary arteries. According to the ERS/ESC classification of pulmonary hypertension (PH) from 2015, PVOD/PCH have been included in the subgroup 1’ of pulmonary arterial hypertension (PAH). Recent data indicate, however, the possibility of PVOD/PCH pathology in the patients diagnosed in the group 1. The problem may concern PAH associated with scleroderma, drug- induced PAH, PAH due to HIV infection and up to 10% of patients with idiopathic PAH (IPAH). Recently, bi-allelic EIF2AK4 mutations were found in the cases with heritable form of PVOD/PCH and in about 9% of sporadic cases. Moreover, an association between occupational exposure to organic solvents and PVOD/PCH was proved. The present review is an attempt to summarise the current data on pathogenesis, risk factors, clinical features and diagnostic algorithm for PVOD/PCH. Full article

376 KiB

Open AccessCase Report

Difficulties in the Treatment of Recurring Diffuse Alveolar Hemorrhage Accompanying Primary Antiphospholipid Syndrome: A Case Report and Literature Review

by Piotr Janowiak, Alicja Siemińska, Maria Porzezińska, Żaneta Smoleńska, Hanna Suchanek and Ewa Jassem

Adv. Respir. Med. 2018, 86(3), 126-130; https://doi.org/10.5603/ARM.2018.0020 - 30 Jun 2018

Cited by 5 | Viewed by 428

Abstract

Pulmonary embolism is the most common pulmonary manifestation of primary antiphospholipid syndrome (PAPS). However, PAPS may manifest in the respiratory system also due to non-thrombotic processes. In the following paper we present a case of PAPS-related diffuse alveolar hemorrhage (DAH). Because of sparse literature and a lack of randomized controlled trials, there are currently no recommendations regarding the optimal choice of steroid-sparing agent in treating PAPS-related DAH. In our patient, treatment with cyclophosphamide or mycophenolate mofetil along with low dose prednisone was ineffective, partially because of infectious complications, whereas addition of monthly intravenous immunoglobulin to mycophenolate mofetil and prednisone, appears to control the disease. Full article

275 KiB

Open AccessArticle

Is a Normal Chest Radiograph Sufficient to Exclude Pulmonary Abnormalities Potentially Associated with Chronic Cough?

by Olga Truba, Aleksandra Rybka, Karolina Klimowicz, Elżbieta M. Grabczak, Małgorzata Żukowska, Marta Dąbrowska and Rafał Krenke

Adv. Respir. Med. 2018, 86(3), 113-120; https://doi.org/10.5603/ARM.2018.0018 - 30 Jun 2018

Cited by 12 | Viewed by 477

Abstract

Introduction: There are few original studies on the true role of normal chest radiograph (CXR) in exclusion of pulmonary conditions that may be associated with chronic cough. Thus, the aim of the study was to assess whether a plain CXR is a sufficient tool to exclude relevant pulmonary causes of chronic cough. Material and methods: A retrospective analysis of chest computed tomography (CT) scans in non-smoking patients with chronic cough and normal CXR was performed. The percentage of individuals in whom chest CT revealed relevant abnormalities was compared with the percentage of patients with irrelevant findings or normal chest CT scans. The negative predictive value (NPV) of the CXR in diagnosing the causes of chronic cough was calculated as a proportion of true negative CXRs (normal CXR AND irrelevant CT findings OR normal CT scan) to all negative CXRs (all patients, who had both a CXR and CT scan). Results: The study group consisted of 59 adult patients with chronic cough, normal CXR and CT scan performed to diagnose the cause of chronic cough. In 21 patients (21/59, 35.6%), chest CT revealed abnormalities that were classified as relevant to chronic cough. The most frequent were: bronchiectasis (7/59, 11.9%), bronchial wall thickening (6/59, 10.2%) and mediastinal lymphadenopathy (5/59, 8.5%). The NPV of a CXR in diagnosing the causes of chronic cough was 64%. Conclusions: In conclusion, the NPV of CXR in diagnosing pulmonary causes of chronic cough is relatively low. Thus, plain CXR seems to be insufficient to exclude pulmonary diseases potentially associated with chronic cough. Full article

323 KiB

Open AccessCase Report

Pulmonary Tuberculosis in a Male with Silicosis

by Marcin Skowroński, Anna Halicka and Aleksander Barinow-Wojewódzki

Adv. Respir. Med. 2018, 86(3), 121-125; https://doi.org/10.5603/ARM.2018.0019 - 20 Feb 2018

Cited by 11 | Viewed by 651

Abstract

Silicosis, a preventable occupational lung disease, is associated with various diseases, including tuberculosis (TB). There is an increased lifelong risk for lung tuberculosis even if exposure to silica dust ceases. That association contributes in a large extent to very high rates of tuberculosis in countries with poor TB and silica exposure control. We report a case of a male with a prior diagnosis of silicosis who was diagnosed with and treated for TB. Anti-tuberculous treatment was extended due to a positive sputum smear in the six th month of treatment. However, the culture of the sputum was negative. This Case Report highlights the value of thorough screening for tuberculosis in silicotic patients. The clinical management of these patients may be challenging due to frequent overlapping radiological features and uncertain results of TB treatment. Full article

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Adv. Respir. Med., Volume 86, Issue 3 (June 2018) – 6 articles , Pages 113-157

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