Advances in Respiratory Medicine

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Open AccessLetter

Is Bronchoscopy Always Justified in Diagnosis of Haemoptysis? Response to the Letter of Solidoro and Guerrera

by Justyna M. Sobczak, Patryk K. Sobczak, Katarzyna K. Torbiarczyk, Joanna Miłkowska-Dymanowska, Adam Antczak, Paweł Górski, Adam J. Białas and Wojciech J. Piotrowski

Adv. Respir. Med. 2018, 86(6), 329; https://doi.org/10.5603/ARM.a2018.0054 - 30 Dec 2018

Viewed by 260

Abstract

Dear Editor [...] Full article

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Open AccessLetter

The Importance of a Diagnostic Pathway in the Diagnosis of Haemoptysis

by Paolo Solidoro and Francesco Guerrera

Adv. Respir. Med. 2018, 86(6), 327-328; https://doi.org/10.5603/ARM.a2018.0053 - 30 Dec 2018

Cited by 2 | Viewed by 241

Abstract

Dear Editor [...] Full article

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Open AccessReview

Idiopathic Pulmonary Fibrosis Coexisting with Lung Cancer

by Michał Zieliński, Piotr Sitek and Dariusz Ziora

Adv. Respir. Med. 2018, 86(6), 319-326; https://doi.org/10.5603/ARM.a2018.0052 - 30 Dec 2018

Cited by 5 | Viewed by 367

Abstract

Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease with poor prognosis. Although the underlying mechanisms are not fully understood, IPF is connected with lung cancer development, which farther worsens the prognosis. Various papers report IPF and cancer coexistence in 9.8% to over [...] Read more.

Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease with poor prognosis. Although the underlying mechanisms are not fully understood, IPF is connected with lung cancer development, which farther worsens the prognosis. Various papers report IPF and cancer coexistence in 9.8% to over 50% of patients depending on observation period. Contrary to already established guidelines in the general population, there are no widely accepted recommendations on lung cancer treatment in IPF population. At the same time, various oncologic interventions can result in acute exacerbation of IPF. In this paper authors tried to revise the available data on lung cancer in patients with preexisting IPF. Full article

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Open AccessReview

Epicardial Fat in Patients with Chronic Obstructive Pulmonary Disease as a Marker of High Cardiovascular Risk

by Milan Sova, Samuel Genzor, Vítězslav Kolek, Filip Čtvrtlík, Amjad Ghazal Asswad, Ondřej Zela and Zdeněk Tauber

Adv. Respir. Med. 2018, 86(6), 314-318; https://doi.org/10.5603/ARM.a2018.0051 - 30 Dec 2018

Cited by 2 | Viewed by 349

Abstract

Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases (CVD) are commonly interconnected, and this coincidence negatively influences patients’ mortality and morbidity. On the basis of the current available data originating mainly from cardiovascular studies epicardial fat (EF) has been proposed as a marker [...] Read more.

Chronic obstructive pulmonary disease (COPD) and cardiovascular diseases (CVD) are commonly interconnected, and this coincidence negatively influences patients’ mortality and morbidity. On the basis of the current available data originating mainly from cardiovascular studies epicardial fat (EF) has been proposed as a marker of cardiovascular risk. This review is focused on a potential role of epicardial fat as a new biomarker for risk stratification of COPD patients. Epicardial fat may present an important link between chronic obstructive pulmonary disease and cardiovascular diseases, mainly coronary artery disease. Full article

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Open AccessCase Report

Development of Bronchiectasis during Long-Term Rituximab Treatment for Rheumatoid Arthritis

by Víctor A. Santos, Gabriel J. Tobón and Carlos A Cañas

Adv. Respir. Med. 2018, 86(6), 310-313; https://doi.org/10.5603/ARM.a2018.0050 - 30 Dec 2018

Cited by 7 | Viewed by 372

Abstract

Here are the cases of three female patients who received long-term rituximab treatment for seropositive, erosive and deforming rheumatoid arthritis were reported. After rituximab treatment, they presented with recurrent sinusitis and pneumonia, followed by the subsequent development of bronchiectasis. A temporal relationship between [...] Read more.

Here are the cases of three female patients who received long-term rituximab treatment for seropositive, erosive and deforming rheumatoid arthritis were reported. After rituximab treatment, they presented with recurrent sinusitis and pneumonia, followed by the subsequent development of bronchiectasis. A temporal relationship between rituximab treatment and the onset of respiratory complications was exposed as a possible pathogenic mechanism. Full article

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Open AccessCase Report

Necrotizing Pneumonia due to Mycoplasma in Children: An Uncommon Presentation of a Common Disease

by Isabel San Martin, Sada Elena Zarikian, Mercedes Herranz and Laura Moreno-Galarraga

Adv. Respir. Med. 2018, 86(6), 305-309; https://doi.org/10.5603/ARM.a2018.0049 - 30 Dec 2018

Cited by 6 | Viewed by 582

Abstract

Mycoplasma pneumoniae is a common respiratory pathogen, especially in children, responsible for community-acquired pneumonia. Although, in most cases, infections caused by this bacterium follow a benign self-limited clinical course, cases of severe respiratory infections have been reported. We present two pediatric cases of [...] Read more.

Mycoplasma pneumoniae is a common respiratory pathogen, especially in children, responsible for community-acquired pneumonia. Although, in most cases, infections caused by this bacterium follow a benign self-limited clinical course, cases of severe respiratory infections have been reported. We present two pediatric cases of necrotizing pneumonia due to Mycoplasma pneumoniae. Both patients initially presented with low-grade fever, cough and mild respiratory symptoms, however, imaging techniques showed necrotizing pneumonia. Initially, a typical bacterial pneumonia was suspected, so antibiotic empiric regimen did not included macrolides. When clinical evolution was not adequate, antibiotic treatment was modified in order to provide coverage to unusual pathogens. Both patients finally recovered once Mycoplasma was suspected, and oral macrolides were added to their treatment. Although M. pneumoniae is a rare cause of necrotizing pneumonia, it must be considered, when usual antibiotic empiric therapy is not being successful. Before thinking of uncommon germs, we must remember that: ‘The unusual presentation of a common disease is generally more likely than the usual presentation of an uncommon disease’. Full article

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Open AccessArticle

Early Maladaptive Schemas and Asthma: Disconnection and Rejection Domains May Have an Effect on the Severity of Asthma

by Masoud Nazemiyeh, Akbar Sharifi, Horiyeh Shojaan, Maryam Mohammadi, Sina Abdkarimi and Morteza Gojazadeh

Adv. Respir. Med. 2018, 86(6), 299-304; https://doi.org/10.5603/ARM.a2018.0048 - 30 Dec 2018

Viewed by 392

Abstract

Introduction: Early maladaptive schemas (EMSs) that are being shaped through the early period of development of humans have been reported to affect the functions of asthmatic patients. This study focuses on the probable relationship between the personality schemas and areas with severity [...] Read more.

Introduction: Early maladaptive schemas (EMSs) that are being shaped through the early period of development of humans have been reported to affect the functions of asthmatic patients. This study focuses on the probable relationship between the personality schemas and areas with severity of asthma. Material and methods: Fifty asthmatic patients were entered this descriptive cross-sectional study in Tabriz University of Medical Sciences from March to August, 2016. We measured the personality schema of patients by using the Young Schema Questionnaire—Short Form (YSQ-SF; Young, 1994). On the other hand, patients’ clinical findings and severity of asthma were assessed by spirometry and the Asthma Control Test (ACT) questionnaire. Results: Uncontrolled (ACT score < 20) and controlled (ACT score ≥ 20) asthma had significant defect in ‘Disconnection domain’ (p = 0.001). Also, significant reverse linear correlation was found between FEV₁ and ‘Disconnection domain’, ‘Rejection’ schema area (r = –0.29, p = 0.03), and ‘Over vigilance domain’ (r = –0,36, p = 0.01). Whereas, significant reverse linear correlation was revealed between FEV₁/FVC and Over vigilance domain (r = –0.41, p = 0.003). Conclusion: EMSs possibly have potential effects on clinical characteristics and severity of asthma in asthmatic patients. Full article

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Open AccessArticle

Nontuberculous Mycobacteria Strains Isolated from Patients between 2013 and 2017 in Poland. Our Data with Respect to the Global Trends

by Sylwia Kwiatkowska, Ewa Augustynowicz-Kopeć, Maria Korzeniewska-Koseła, Dorota Filipczak, Paweł Gruszczyński, Anna Zabost, Magdalena Klatt and Małgorzata Sadkowska-Todys

Adv. Respir. Med. 2018, 86(6), 291-298; https://doi.org/10.5603/ARM.a2018.0047 - 30 Dec 2018

Cited by 8 | Viewed by 423

Abstract

Introduction: During the last decades the prevalence of NTM infections has increased, especially in developed countries. The aim of the study was to provide an overview on all NTM isolated from clinical samples in Poland between 2013 and 2017. Material and methods [...] Read more.

Introduction: During the last decades the prevalence of NTM infections has increased, especially in developed countries. The aim of the study was to provide an overview on all NTM isolated from clinical samples in Poland between 2013 and 2017. Material and methods: The study comprised 2799 clinical specimens, mostly respiratory accessed in the reference laboratory of National Tuberculosis and Lung Diseases Research Institute in Warsaw and in the Wielkopolska Center of Pulmonology and Thoracic Surgery, Poland, 2013–2017. Results: During the study period 35 species of NTM were isolated. The number of isolates increased almost 1.6-fold: from 420 in 2013 to 674 in 2017. M. kansasii, M. avium, M. xenopi, M. gordonae and M. intracellulare were the most common species. This NTM pattern was rather stable over the time. If the aggregated amount of all MAC species was taken into account they dominated over M. kansasii from 2015. M. avium and M. intracellulare were more often isolated from women, while M. kansasii, M. gordonae and M. xenopi predominated in men. Men and women were infected almost with the same frequency. In older patients 65+ women were in majority, quite opposite to those aged 25 to 64 years. Conclusion: In Poland, like in other countries increased frequency of isolated NTM. M. kansasii and M. avium were the most frequently identified species from clinical samples. Men and women were infected with NTM with the same frequency. Full article

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Open AccessArticle

Influence of Omalizumab Therapy on Airway Remodeling Assessed with High-Resolution Computed Tomography (HRCT) in Severe Allergic Asthma Patients

by Marek Przybyszowski, Kinga Paciorek, Weronika Zastrzeżyńska, Agnieszka Gawlewicz-Mroczka, Anna Trojan-Królikowska, Anna Orłowska, Jerzy Soja, Wiesław Pawlik and Krzysztof Sładek

Adv. Respir. Med. 2018, 86(6), 282-290; https://doi.org/10.5603/ARM.a2018.0046 - 30 Dec 2018

Cited by 8 | Viewed by 483

Abstract

Introduction: Airway remodeling is an important factor in persistent obstruction in severe asthma. High resolution computed tomography (HRCT) is an effective method of detecting changes in airway structure. Our aim was to use HRCT to assess changes in airway remodeling in patients [...] Read more.

Introduction: Airway remodeling is an important factor in persistent obstruction in severe asthma. High resolution computed tomography (HRCT) is an effective method of detecting changes in airway structure. Our aim was to use HRCT to assess changes in airway remodeling in patients with severe allergic asthma who are treated with omalizumab. Material and methods: In 12 patients with severe allergic asthma, HRCT was performed before and after treatment with omalizumab. In selected bronchial airways, parameters were calculated: bronchial wall area (BA), also corrected for body surface area (BSA); percentage of wall area (WA%); and the ratio of luminal area to total bronchial area (Ai/Ao). Clinical response to treatment was assessed using an asthma control questionnaire (ACQ), asthma quality of life questionnaire (AQLQ), and number of exacerbations per year. Assessment included spirometry and blood eosinophilia. Results: Treatment resulted in significant improvement in ACQ (p = 0.035) and AQLQ (p = 0.001). We observed significant reduction in exacerbations per year (p = 0.002) and reduction of daily systemic steroid dose (p = 0.032). FEV₁ and peripheral blood eospinophilia did not change (p = 0.846 and p = 0.221). Airway dimensions (Ai/Ao) of particular bronchi were consistent with the mean of the parameters calculated for all bronchi measured. Although we observed a significant decrease in WA (p = 0.002) and WA/BSA (p = 0.002), WA% and Ai/Ao did not improve (p = 0.39 and p = 0.49). We found no correlations between changes in airways and changes in spirometry or clinical parameters. Conclusion: Despite clinical effectiveness of omalizumab, its effect on airway remodeling may be limited. Full article

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Open AccessArticle

Comparing Transpulmonary Thermodilution Monitoring to Lung Ultrasound during Pneumonia: An Observational Study

by Konrad Mendrala, Dariusz Gajniak, Tomasz Cyzowski, Tomasz Czober, Danuta Gierek and Ewa Kucewicz-Czech

Adv. Respir. Med. 2018, 86(6), 275-281; https://doi.org/10.5603/ARM.a2018.0045 - 30 Dec 2018

Viewed by 325

Abstract

Introduction: Monitoring of lung function during pneumonia is essential for the evaluation of the effectiveness of therapy in ICU patients. Among various bedside techniques, two particularly interesting are the lung ultrasound and the transpulmonary thermodilution technique. In this observational single center study [...] Read more.

Introduction: Monitoring of lung function during pneumonia is essential for the evaluation of the effectiveness of therapy in ICU patients. Among various bedside techniques, two particularly interesting are the lung ultrasound and the transpulmonary thermodilution technique. In this observational single center study we wanted to assess the correlation between the lung ultrasound examination (LUS) and transpulmonary thermodilution volumetric parameters such as extravascular lung water index (EVLWI) and pulmonary vascular permeability index (PVPI). Material and methods: We analyzed data obtained from medical history of twelve patients requiring mechanical ventilation and hemodynamics monitoring with PICCO catheter due to newly diagnosed pneumonia. We compared lung ultrasound examination performed on the first and third day of new antimicrobial therapy with results of transpulmonary thermodilution examination made on the same day. We also calculated the difference between values obtained on first and third day to compare the trends. Results: We did not find any association between tested variables, except a correlation between PVPI and EVLWI, both measured at the same day (Rho = 0.3; 95%CI –0.02–0.59; p = 0.03), and trends in the period of 3 days (Rho = 0.6; 95%CI 0.2–0.8; p = 0.005). Conclusions: The results of the study indicate that volumetric values achieved using the PiCCO method as well as lung ultrasound should be interpreted with care and related to the clinical state of a patient, keeping in mind that no correlation between the result achieved and the actual state of inflammatory changes in the lungs may be possible. Full article

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Open AccessArticle

Speech Therapy in the Management of Difficult-to-Treat Chronic Cough—Preliminary Results

by Marta Dąbrowska, Elżbieta M. Grabczak, Dorota Rojek, Anna Łobacz, Karolina Klimowicz, Olga Truba, Aleksandra Rybka, Antoni Krzeski and Rafał Krenke

Adv. Respir. Med. 2018, 86(6), 268-274; https://doi.org/10.5603/ARM.a2018.0044 - 30 Dec 2018

Cited by 1 | Viewed by 416

Abstract

Introduction: The efficacy of management of chronic cough in adults is limited. Speech therapy is one of the few therapeutic methods which seems to be useful in patients with persistent chronic cough. However, the method has not been available in Poland so [...] Read more.

Introduction: The efficacy of management of chronic cough in adults is limited. Speech therapy is one of the few therapeutic methods which seems to be useful in patients with persistent chronic cough. However, the method has not been available in Poland so far. The aim of the study was to implement speech therapy and assess its efficacy in the management of patients with difficult-to-treat chronic cough. Material and methods: Patients, who were diagnosed and managed due to difficult-to-treat chronic cough, were enrolled into the study. Speech therapy was developed on the basis of the technique described by Vertigan. The entire therapy consisted of eight weekly sessions, each lasting 45 minutes. Before and after speech therapy, cough severity and its impact on the quality of life was assessed by the Visual Analogue Scale (VAS) and Leicester Cough Questionnaire (LCQ). Additionally, cough challenge test with capsaicin was performed. Results: Eighteen women were enrolled into the study, 15 of them (83%) attended all treatment sessions (median age 66 years, median duration of cough 60 months). There was a significant decrease in cough severity measured by VAS (46 vs. 28 mm, p = 0.016) after completion of speech therapy. A significant improvement in patients’ quality of life measured by LCQ (10.7 vs. 14.6 points, p = 0.004) and an increase in the threshold of cough reflex measured by capsaicin challenge were also demonstrated. Conclusions: Speech therapy resulted in a decrease in cough severity and improvement of quality of life of females with refractory chronic cough. Our results support the use of speech therapy as add-on treatment in females with difficult-to-treat cough. Full article

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Open AccessArticle

Factors Predisposing to Non-Tuberculous Mycobacterial Lung Disease in the Patients with Respiratory Isolates of Non-Tuberculous Mycobacteria

by Monika Szturmowicz, Izabela Siemion-Szcześniak, Dorota Wyrostkiewicz, Magdalena Klatt, Sylwia Brzezińska, Anna Zabost, Anna Lewandowska, Dorota Filipczak, Karina Oniszh, Agnieszka Skoczylas, Ewa Augustynowicz-Kopeć and Jan Kuś

Adv. Respir. Med. 2018, 86(6), 261-267; https://doi.org/10.5603/ARM.a2018.0043 - 30 Dec 2018

Cited by 9 | Viewed by 468

Abstract

Introduction: An increasing incidence rate of respiratory isolates of non-tuberculous mycobacteria (NTM) has been noted recently in most European countries as well as in the US. Despite many publications, there is no consensus concerning the importance of different factors in promoting NTM [...] Read more.

Introduction: An increasing incidence rate of respiratory isolates of non-tuberculous mycobacteria (NTM) has been noted recently in most European countries as well as in the US. Despite many publications, there is no consensus concerning the importance of different factors in promoting NTM lung disease (NTMLD). The aim of the present retrospective study was to analyse patients with positive NTM respiratory isolates in search of factors predisposing to NTMLD. Material and methods: 73 patients, 23 males, 50 females, median age 62.2 years, in whom NTM have been cultured from respiratory specimen (sputum and/or bronchial washings), in the period 2010–2015, entered the study. Results: NTMLD (according to ATS/IDSA) has been recognised in 36 patients, airways colonisation by NTM—in 37 patients. NTMLD was diagnosed more often in the patients infected with M. kansasii, M. abscessus and M. avium/M. intracellulare comparing to those infected with M. xenopi, M. gordonae and M. fortuitum (p < 0.0001). The proportion of females to males was significantly higher in the NTMLD group comparing to the colonisation group (p < 0.007). Previous tuberculosis or mycobacteriosis were noted significantly more frequently in the group of patients with NTMLD comparing to the colonisation group (28% vs. 8%, p = 0.038). Univariate regression analysis revealed M. kansasii, female gender, and previous tuberculosis or mycobacteriosis as significant predictors of NTMLD. Conclusions: The risk factors of NTMLD recognition in the presented group of patients were the following: female gender, M. kansasii isolation, as well as past tuberculosis or mycobacteriosis. Full article

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Adv. Respir. Med., Volume 86, Issue 6 (December 2018) – 12 articles , Pages 261-329

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