Advances in Respiratory Medicine

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Open AccessLetter

Should I Stay or Should I Go? Pulmonary Embolism and Air Travel

by Ioannis Pantazopoulos and Konstantinos Gourgoulianis

Adv. Respir. Med. 2019, 87(6), 277; https://doi.org/10.5603/ARM.2019.0070 - 14 Jan 2020

Viewed by 760

The global rise in air travel, with over 3.97 billion people traveling by air each year, and the aging population, increase the number of those with an illness who wish to travel [...] Full article

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Open AccessLetter

Integrating Multi-Disciplinary Discussion in Clinical Practice

by Ilias C. Papanikolaou, Andreas Afthinos, Alexandra Papoudou-Bai and Panagiotis Repousis

Adv. Respir. Med. 2019, 87(6), 274-276; https://doi.org/10.5603/ARM.2019.0069 - 14 Jan 2020

Viewed by 286

Abstract

A 68 year-old male was referred to our clinic in order to investigate an abnormal chest radiography that was performed during work-up of an anemia with unknown onset [...] Full article

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Open AccessCase Report

Isolated Persistent Left Superior Vena Cava in a Young Adult without Cardiac Disease

by Satyajeet Sahoo and Manoj Kumar Panigrahi

Adv. Respir. Med. 2019, 87(6), 272-273; https://doi.org/10.5603/ARM.2019.0068 - 14 Jan 2020

Viewed by 297

Abstract

A 30-year-old non-diabetic, normotensive male presented to our outpatient department with intermittent left-sided chest pain that had bothered him for the last 3 years [...] Full article

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Open AccessCase Report

An Uncommon Cause of Hemoptysis in Pulmonary Tuberculosis

by Nitesh Gupta, Juvva Kishan Srikanth, Puneet Garg, Pranav Ish and Shibdas Chakrabarti

Adv. Respir. Med. 2019, 87(6), 270-271; https://doi.org/10.5603/ARM.2019.0067 - 14 Jan 2020

Cited by 2 | Viewed by 353

Abstract

A sixty-year-old woman, diabetic on oral hypoglycemic, presented with complaints of low-grade fever, cough with scanty sputum, breathlessness since 3 weeks followed by streaky hemoptysis for five days [...] Full article

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Open AccessCase Report

Cystic Lung Disease in an Adult Non-Smoker

by Ambarish Joshi, Nitesh Gupta, Pranav Ish and Shibdas Chakrabarti

Adv. Respir. Med. 2019, 87(6), 268-269; https://doi.org/10.5603/ARM.2019.0066 - 14 Jan 2020

Viewed by 277

Abstract

A 33-year-old non-smoking male who was a farmer by trade and had no other comorbidities presented with complaints of shortness of breath, left sided chest pain and dry cough which had bothered him for over the past 7 days [...] Full article

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Open AccessCase Report

Not Everything Is What It Seems: Malignant Pleural Mesothelioma Mimicking Lung Cancer

by Elena Prisciandaro, Lara Girelli, Cristiano Rampinelli, Mariacristina Ghioni and Lorenzo Spaggiari

Adv. Respir. Med. 2019, 87(6), 265-267; https://doi.org/10.5603/ARM.2019.0065 - 14 Jan 2020

Cited by 2 | Viewed by 343

Abstract

Malignant pleural mesothelioma usually arises from the pleural surface and progressively encases the lungs. Pulmonary involvement generally occurs at an advanced stage, while intraparenchymal nodules, in the absence of pleural lesions, constitute a less frequent presentation. We describe the case of a patient [...] Read more.

Malignant pleural mesothelioma usually arises from the pleural surface and progressively encases the lungs. Pulmonary involvement generally occurs at an advanced stage, while intraparenchymal nodules, in the absence of pleural lesions, constitute a less frequent presentation. We describe the case of a patient with multiple bilateral pulmonary nodules, mediastinal lymphadenopathies and left pleural effusion in the absence of pleural lesions, simulating advanced stage lung cancer. Thoracoscopic inspection did not detect any lesions. Pathological examination on one pulmonary nodule revealed malignant pleural mesothelioma. Despite its rarity, intraparenchymal malignant pleural mesothelioma should always be taken into account, when lung nodules are present, to prevent misdiagnosis and avoid delayed treatment Full article

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Open AccessCase Report

Difficulties in Recognizing Granulomatosis with Polyangiitis (GPA) in Elderly Patients Undergoing Diagnostic Thoracotomy Twice—A Report of Two Cases

by Justyna Fijołek, Elżbieta Wiatr, Dariusz Gawryluk, Renata Langfort and Kazimierz Roszkowski-Śliż

Adv. Respir. Med. 2019, 87(6), 258-264; https://doi.org/10.5603/ARM.2019.0064 - 14 Jan 2020

Cited by 2 | Viewed by 390

Abstract

Granulomatosis with polyangiitis (GPA) is defined as a necrotizing granulomatous inflammation usually involving the upper and lower respiratory tract with necrotizing vasculitis affecting predominantly small to medium vessels. Because of non-specific symptoms, its radiological presentation, and the diversity of its clinical expression, it [...] Read more.

Granulomatosis with polyangiitis (GPA) is defined as a necrotizing granulomatous inflammation usually involving the upper and lower respiratory tract with necrotizing vasculitis affecting predominantly small to medium vessels. Because of non-specific symptoms, its radiological presentation, and the diversity of its clinical expression, it is not uncommon to for it to be misdiagnosed, especially in the elderly. Although biopsy and histological examination seem to be essential for GPA diagnosis, their results are sometimes ambiguous and not helpful in making a decision. In this report, we present difficulties in the recognition of GPA in two elderly patients in whom, despite twice performing a diagnostic thoracotomy, GPA was recognized almost 4 and 6 years after the first symptoms. Full article

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Open AccessCase Report

Exogenous Lipoid Pneumonia Induced by Nasal Instillation of Paraffin Oil

by Małgorzata Bartosiewicz, Katarzyna Zimna, Katarzyna Lewandowska, Małgorzata Sobiecka, Małgorzata Dybowska, Piotr Radwan-Rohrenschef, Monika Szturmowicz and Witold Tomkowski

Adv. Respir. Med. 2019, 87(6), 254-257; https://doi.org/10.5603/ARM.2019.0063 - 14 Jan 2020

Cited by 1 | Viewed by 453

Abstract

Lipoid pneumonia is a rare pulmonary disease, classified in terms of the source of lipid exposure into two variants: exogenous and endogenous. We present a patient with exogenous lipoid pneumonia, acquired after chronic exposure to paraffin oil-containing nasal drops. The diagnosis was established [...] Read more.

Lipoid pneumonia is a rare pulmonary disease, classified in terms of the source of lipid exposure into two variants: exogenous and endogenous. We present a patient with exogenous lipoid pneumonia, acquired after chronic exposure to paraffin oil-containing nasal drops. The diagnosis was established by demonstration of lipid-laden macrophages in bronchoalveolar lavage, chest computed tomography results and a history of lipid exposure. Full article

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Open AccessReview

Atypical Manifestations of Granulomatosis with Polyangiitis: The Diagnostic Challenge for Pulmonologists

by Amelia Szymanowska-Narloch, Dariusz Gawryluk, Katarzyna Błasińska-Przerwa and Alicja Siemińska

Adv. Respir. Med. 2019, 87(6), 244-253; https://doi.org/10.5603/ARM.2019.0062 - 14 Jan 2020

Cited by 5 | Viewed by 536

Abstract

This is a review considering atypical manifestations of granulomatosis with polyangiitis (GPA). Virtually any organ can be affected, and in some patients, GPA can manifest unusually. Since thoracic involvement of GPA often predominates, the first who might be expected to establish a diagnosis [...] Read more.

This is a review considering atypical manifestations of granulomatosis with polyangiitis (GPA). Virtually any organ can be affected, and in some patients, GPA can manifest unusually. Since thoracic involvement of GPA often predominates, the first who might be expected to establish a diagnosis are pulmonary specialists. We would like to familiarize pulmonary specialists with several extra-ELK (E: ear-nose-throat; L: lung; K: kidney) involvements of the disease. We describe sites rarely affected by GPA like the breast, skeletal system, orbit and eye, heart and vessels, central nervous system, urogenital system as well as endocrine and gastrointestinal tract involvement. Full article

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Open AccessReview

Advances in the Diagnosis and Management of Pulmonary Aspergillosis

by Yuqing Gao and Ayman O. Soubani

Adv. Respir. Med. 2019, 87(6), 231-243; https://doi.org/10.5603/ARM.2019.0061 - 14 Jan 2020

Cited by 20 | Viewed by 807

Abstract

Aspergillus is a mould that is ubiquitous in nature and may lead to a variety of infectious and allergic diseases depending on the host's immune status or pulmonary structure. Invasive pulmonaryaspergillosisoccurs primarily in patients with severe immunodeficiency. The significance of this infection has [...] Read more.

Aspergillus is a mould that is ubiquitous in nature and may lead to a variety of infectious and allergic diseases depending on the host's immune status or pulmonary structure. Invasive pulmonaryaspergillosisoccurs primarily in patients with severe immunodeficiency. The significance of this infection has dramatically increased with growing numbers of patients with impaired immune state associated with the management of malignancy, organ transplantation, autoimmune and inflammatory conditions; critically ill patients appear to be at an increased risk as well. The introduction of new noninvasive tests, combined with more effective and better-tolerated antifungal agents, has resulted in lower mortality rates associated with this infection. Chronic pulmonary aspergillosis is a locally invasive disease described in patients with chronic lung disease or mild immunodeficiency. Recently, the European Society for Clinical Microbiology and Infectious Diseases provided a more robust sub-classification of this entity that allows for a straightforward approach to diagnosis and management. Allergic bronchopulmonaryaspergillosis, a hypersensitivity reaction to Aspergillus antigens, is generally seen in patients with atopy, asthma or cystic fibrosis. This review provides an update on the evolving epidemiology and risk factors of the major manifestations of Aspergillus lung disease and the clinical manifestations that should prompt the clinician to consider these conditions. It also details the role of noninvasive tests in the diagnosis of Aspergillus related lung diseases and advances in the management of these disorders. Full article

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Open AccessArticle

Diagnostic and Treatment Standards in Idiopathic Pulmonary Fibrosis in the Era of Antifibrotic Drugs in Poland: A Real-World Practice Survey

by Sebastian Majewski, Katarzyna Lewandowska, Magdalena Maria Martusewicz-Boros and Wojciech Jerzy Piotrowski

Adv. Respir. Med. 2019, 87(6), 221-230; https://doi.org/10.5603/ARM.2019.0060 - 14 Jan 2020

Cited by 3 | Viewed by 530

Abstract

Introduction: Currently, only two drugs have been shown to modify the inevitable natural history of idiopathic pulmonary fibrosis (IPF). Changes in the reimbursement policy for antifibrotic drugs in Poland have led to the availability of pirfenidone from January 2017 and nintedanib from [...] Read more.

Introduction: Currently, only two drugs have been shown to modify the inevitable natural history of idiopathic pulmonary fibrosis (IPF). Changes in the reimbursement policy for antifibrotic drugs in Poland have led to the availability of pirfenidone from January 2017 and nintedanib from March 2018 for the treatment of Polish patients with IPF. This study aimed to evaluate the possible changes and shortcomings in the clinical practice standards in IPF in the era of access to antifibrotic therapy in Poland. Material and methods: A real-world data survey was performed among physicians attending the Polish Respiratory Society Congress held in May 2018. The present survey was a follow-up to the previous survey undertaken in 2016, before the availability of antifibrotics in Poland. Results: A total of 99 physicians participated in the survey, among which 80% were pulmonologists. The majority of participants (83%) represented hospital-based clinicians and most of them (93%) were involved in interstitial lung diseases (ILD) management. As many as 63% of the respondents elaborate the final diagnosis of IPF working with the expert radiologist routinely, 47% do that in the cooperation with other pulmonologists, and if a biopsy was performed 39% discuss its results with the expert pathologist. Bronchoalveolar lavage (BAL) and surgical lung biopsy (SLB) would never be recommended in the differential diagnosis of IPF by 9% and 16% of the respondents, respectively. Corticosteroids (CS) or a combination of CS and immunosuppressants (IS) is still recommended by 22% of participants. Proton pump inhibitors (PPI) in the case of symptomatic GERD are prescribed by 44% of the respondents, and 12% prescribe PPI regardless of GERD symptoms. Pirfenidone is used by 70%, and nintedanib by 48% of the respondents. Only 39% of the respondents refer patients with IPF to professional rehabilitation centers. Conclusions: The level of cooperation between pulmonologists and other specialists in the diagnostic workup of IPF is unsatisfactory. IPF treatment practices in the era of access to effective drugs in Poland require immediate improvement. There is an urgent need to develop the local Polish practical Guideliness to improve the management of IPF. Full article

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Open AccessArticle

Does Bronchiectasis Affect Chronic Obstructive Pulmonary Disease Comorbidities?

by Adam Nowiński, Damian Korzybski, Michał Bednarek, Anna Goljan-Geremek, Elżbieta Puścińska and Paweł Śliwiński

Adv. Respir. Med. 2019, 87(6), 214-220; https://doi.org/10.5603/ARM.2019.0059 - 14 Jan 2020

Cited by 4 | Viewed by 648

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD) and bronchiectasis, chronic inflammation disorders of the bronchial tree through the mechanism of 'spill-over' of inflammatory mediators, may lead to systemic manifestations of illness of the respiratory system and comorbidities. The aim of the study was [...] Read more.

Introduction: Chronic obstructive pulmonary disease (COPD) and bronchiectasis, chronic inflammation disorders of the bronchial tree through the mechanism of 'spill-over' of inflammatory mediators, may lead to systemic manifestations of illness of the respiratory system and comorbidities. The aim of the study was to evaluate the frequency of coexisting chronic obstructive pulmonary disease and bronchiectasis and influence of bronchiectasis on COPD comorbid diseases. Material and methods: A post-hoc cross-sectional analysis of cohort study of 288 consecutive patients hospitalized due to acute exacerbation of COPD was performed. Results: 177 males (61.5%) and 111 females (38.5%) with mean age = 71.0 8 ± 8.9 yrs, FEV1 % pred. = 34.6 ± 16.8 with COPD diagnosis were studied. In this group, 29 (10.1%) patients presented with bronchiectasis confirmed by HRCT scan. COPD patients with and without bronchiectasis had similar Charlson index results (2.5 vs. 2.1, p = 0.05). COPD patients with bronchiectasis required longer hospitalization during exacerbation. COPD patients with bronchiectasis significantly more often than patients without this comorbidity revealed the features of colonization with P. aeruginosa (OR = 4.17, p = 0.02). Conclusions: Bronchiectasis is a relatively common comorbidity in COPD patients. COPD patients with bronchiectasis are more frequently colonized with P. aruginosa comparing to non-bronchiectasis COPD patients. We did not confirm the influence of bronchiectasis on COPD comorbidities. Full article

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Open AccessArticle

Social Networks and Traditional Metrics of Impact in Pulmonary Medicine Journals: A Correlation Study

by Daniela Patino-Hernandez, Daniel Gerardo Fernández-Ávila, Carlos Andrés Celis-Preciado and Oscar Mauricio Munoz-Velandia

Adv. Respir. Med. 2019, 87(6), 209-213; https://doi.org/10.5603/ARM.2019.0058 - 14 Jan 2020

Cited by 2 | Viewed by 453

Abstract

Introduction: The Scimago Journal Rank (SJR) impact factor is extensively used. However, as the Internet has become widely available, new metrics are coming into play. Our research aims to determine whether a correlation between the SJR impact factor and metrics reflecting social [...] Read more.

Introduction: The Scimago Journal Rank (SJR) impact factor is extensively used. However, as the Internet has become widely available, new metrics are coming into play. Our research aims to determine whether a correlation between the SJR impact factor and metrics reflecting social media activity does exist. Materials and methods: We have used pulmonary medicine journals indexed in the SJR. Variables of social network usage have been extracted from verified accounts. Bivariate analyses have been performed with the Mann-Whitney U tests, the correlation between social media-derived variables and the SJR impact factor have been assessed with the Spearman correlation coefficient. Results are presented before and after adjustment for the years since the creation of the accounts. Results: From 130 journals, 38 had at least one social network account, Twitter being the most commonly used (22.85%). The H index was higher in journals with social network accounts (Median 60 vs. 17; p < 0.01). The global correlation between the SJR and the number of followers on Twitter revealed moderate agreement (r = 0.46; p < 0.01), which was excellent in open access journals (rs = 0.90; p < 0.05). Conclusions: The use of social networks is directly correlated with traditional indicators of scientific impact. The joint use of alternative and traditional metrics may be useful for journals in order to generate strategies aiming to increase their audience, as well as for researchers when deciding about the best option of disseminating their articles. Full article

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Open AccessArticle

Relationship between CHA2DS2-VASc and CHADS2 Scores with Pulmonary Hypertension in Patients with Acute Pulmonary Embolism

by Samet Yilmaz, Yalin Tolga Yaylali, Mevlüt Serdar Kuyumcu, Sefa Ünal, Hande Senol and Omac Tufekcioglu

Adv. Respir. Med. 2019, 87(6), 203-208; https://doi.org/10.5603/ARM.2019.0057 - 14 Jan 2020

Cited by 2 | Viewed by 399

Abstract

Introduction: Pulmonary hypertension (PH) is the most important prognostic factor after acute pulmonary embolism (PE). Therefore, determination of patients who will develop PH after acute PE is crucial. The aim of the present study was to evaluate the predictive value of the [...] Read more.

Introduction: Pulmonary hypertension (PH) is the most important prognostic factor after acute pulmonary embolism (PE). Therefore, determination of patients who will develop PH after acute PE is crucial. The aim of the present study was to evaluate the predictive value of the CHADS2 and CHA2DS2-VASc scores for PH in patients with acute PE. Material and methods: Seventy-nine adults who presented with acute PE, had an admission systolic pulmonary artery pressure (sPAP) measured on echocardiogram and no previous history of PE, were retrospectively identified from the computerized database. 31 patients who had sPAP ≤ 40 mm Hg were categorized as a “normal pulmonary pressure” group, whereas 48 patients who had sPAP > 40 mm Hg were categorized as a “PH” group. Results: SPAP was > 40 mm Hg in 48 patients (60.8%), with a mean sPAP of 60.9 ± 16.1 mm Hg (median = 60, min–max = 41–100 mm Hg). In multivariate logistic regression models adjusted for CHADS2 and CHA2DS2-VASc score components, only age was found to be related with the development of PH. SPAP was weakly positively correlated with CHADS2 (p = 0.047; r = 0.224) and CHA2DS2-VASc (p = 0.023; r = 0.256) scores. SPAP values were increasing with the severity of the scores. Conclusions: Both CHADS2 and CHA2DS2-VASc scores could be useful in the determination of which patients should be closely followed up in order to prevent the development of PH after acute PE. Full article

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Adv. Respir. Med., Volume 87, Issue 6 (December 2019) – 14 articles , Pages 203-277

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